24D2162939 CLIA NUMBER - SUNRISE RESIDENTIAL SERVICES

Laboratory Demographics

  • CLIA Code: 24D2162939
  • Facility Name: SUNRISE RESIDENTIAL SERVICES
  • Facility Address: 216 MAPLE LN
    ROSEVILLE, MN
    ZIP 55113
  • Facility Phone: 952 465-8087
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: MUSTAFA H. MUSSE
  • NPI Number: 1477055796
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 24D2162939
LAB Type Assisted Living Facility
Facility Name SUNRISE RESIDENTIAL SERVICES
Street 216 MAPLE LN
City ROSEVILLE
State MN
ZIP 55113
Phone 952 465-8087
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/5/2025
Certificate Expiration Date 3/4/2027
Facility Type Assisted Living Facility
Lab Director MUSTAFA H. MUSSE

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