24D2166252 CLIA NUMBER - MIDWEST RESIDENTIAL

Laboratory Demographics

CLIA Code: 24D2166252
Facility Name: MIDWEST RESIDENTIAL
Facility Address: 10325 ZINRAN AVE S
BLOOMINGTON, MN
ZIP 55438
Facility Phone: 651 315-2649
Facility Type: Assisted Living Facility
Facility Type: Waiver
Lab Director: FAIZA HASSAN
NPI Number: 1578075750
Taxonomy: 320600000X - Residential Treatment Facility, Intellectual and/or Developmental Disabilities

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CLIA Record

Field Name	Field Value
CLIA Number	24D2166252
LAB Type	Assisted Living Facility
Facility Name	MIDWEST RESIDENTIAL
Street	10325 ZINRAN AVE S
City	BLOOMINGTON
State	MN
ZIP	55438
Phone	651 315-2649
Certificate Type	Certificate of Waiver
Certificate Type Description	This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date	5/14/2025
Certificate Expiration Date	5/13/2027
Facility Type	Assisted Living Facility
Lab Director	FAIZA HASSAN

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