24D2171867 CLIA NUMBER - OKALEE OF MEDINA

Laboratory Demographics

  • CLIA Code: 24D2171867
  • Facility Name: OKALEE OF MEDINA
  • Facility Address: 4350 CHIPPEWA CT C/O DIRECTOR OF HEALTH SERVICES
    MEDINA, MN
    ZIP 55340
  • Facility Phone: 763 762-5400
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: JESSICA FUDALI
  • NPI Number: 1154943199
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 24D2171867
LAB Type Assisted Living Facility
Facility Name OKALEE OF MEDINA
Street 4350 CHIPPEWA CT C/O DIRECTOR OF HEALTH SERVICES
City MEDINA
State MN
ZIP 55340
Phone 763 762-5400
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/10/2025
Certificate Expiration Date 9/9/2027
Facility Type Assisted Living Facility
Lab Director JESSICA FUDALI

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