24D2138614 CLIA NUMBER - PRIMUS INCORPORATED

Laboratory Demographics

  • CLIA Code: 24D2138614
  • Facility Name: PRIMUS INCORPORATED
  • Facility Address: 7309 KENTUCKY AVENUE NORTH
    BROOKLYN PARK, MN
    ZIP 55428
  • Facility Phone: 763 732-3729
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: TAIWO R. OBAZELUWA-AFOLAYAN
  • NPI Number: 1316494032
  • Taxonomy: 251S00000X - Community/Behavioral Health

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CLIA Record

Field Name Field Value
CLIA Number 24D2138614
LAB Type Assisted Living Facility
Facility Name PRIMUS INCORPORATED
Street 7309 KENTUCKY AVENUE NORTH
City BROOKLYN PARK
State MN
ZIP 55428
Phone 763 732-3729
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/23/2023
Certificate Expiration Date 10/22/2025
Facility Type Assisted Living Facility
Lab Director TAIWO R. OBAZELUWA-AFOLAYAN

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This page was last updated on: 3/20/2025