24D2134358 CLIA NUMBER - NICE HEALTHCARE, LLC

Laboratory Demographics

CLIA Number: 24D2134358

Facility Name: NICE HEALTHCARE, LLC

Facility Address:
2786 FAIRVIEW AVE N
ROSEVILLE, MN
ZIP 55113
Get Directions

Facility Phone Number: 651 334-0720

Facility Type: Practitioner Other

Certificate Type: Waiver

NPI Number: 1073071239

Taxonomy: 363LP2300X - Nurse Practitioner

CLIA Record

Field Name	Field Value
CLIA Number	24D2134358
LAB Type	Practitioner Other
Facility Name	NICE HEALTHCARE, LLC
Street	2786 FAIRVIEW AVE N
City	ROSEVILLE
State	MN
ZIP	55113
Phone	651 334-0720
CertificateType	4
CertificateEffectiveDate	8/1/2023
CertificateExpirationDate	7/31/2025
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

This page was last updated on: 4/23/2024