24D2138722 CLIA NUMBER - HENNEPIN COUNTY WIC PROGRAM NORTHWEST FAMILY SERVICE CENTER

Laboratory Demographics

  • CLIA Code: 24D2138722
  • Facility Name: HENNEPIN COUNTY WIC PROGRAM NORTHWEST FAMILY SERVICE CENTER
  • Facility Address: 7051 BROOKLYN BLVD
    BROOKLYN CENTER, MN
    ZIP 55429
  • Facility Phone: 612 348-6143
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: JILL WILSON
  • NPI Number: 1518303601
  • Taxonomy: 251S00000X - Community/Behavioral Health

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CLIA Record

Field Name Field Value
CLIA Number 24D2138722
LAB Type Community Clinic
Facility Name HENNEPIN COUNTY WIC PROGRAM NORTHWEST FAMILY SERVICE CENTER
Street 7051 BROOKLYN BLVD
City BROOKLYN CENTER
State MN
ZIP 55429
Phone 612 348-6143
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/24/2023
Certificate Expiration Date 10/23/2025
Facility Type Community Clinic
Lab Director JILL WILSON

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This page was last updated on: 9/29/2025