24D2160297 CLIA NUMBER - VALLEY MEDICAL AND WELLNESS

Laboratory Demographics

CLIA Number: 24D2160297

Facility Name: VALLEY MEDICAL AND WELLNESS

Facility Address:
2847 JOHNSON STREET NE
MINNEAPOLIS, MN
ZIP 55418
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Facility Phone Number: 612 444-3000

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1982223566

Taxonomy: 246RM2200X - Technician, Pathology

CLIA Record

Field Name	Field Value
CLIA Number	24D2160297
LAB Type	Physician Office
Facility Name	VALLEY MEDICAL AND WELLNESS
Street	2847 JOHNSON STREET NE
City	MINNEAPOLIS
State	MN
ZIP	55418
Phone	612 444-3000
CertificateType	4
CertificateEffectiveDate	1/8/2023
CertificateExpirationDate	1/7/2025
FacilityType	Waiver

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