24D2172546 CLIA NUMBER - ST PAUL ORAL SURGERY AND DENTAL IMPLANTS

Laboratory Demographics

  • CLIA Code: 24D2172546
  • Facility Name: ST PAUL ORAL SURGERY AND DENTAL IMPLANTS
  • Facility Address: 750 MAIN ST, SUITE 203
    MENDOTA HEIGHTS, MN
    ZIP 55118
  • Facility Phone: 651 286-8118
  • Facility Type: Other - DENTAL CLINIC SPECIALITY
  • Facility Type: Waiver
  • Lab Director: MARTINA HOVEY
  • NPI Number: 1518395805
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 24D2172546
LAB Type Other - DENTAL CLINIC SPECIALITY
Facility Name ST PAUL ORAL SURGERY AND DENTAL IMPLANTS
Street 750 MAIN ST, SUITE 203
City MENDOTA HEIGHTS
State MN
ZIP 55118
Phone 651 286-8118
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/2/2025
Certificate Expiration Date 1/1/2027
Facility Type Other - DENTAL CLINIC SPECIALITY
Lab Director MARTINA HOVEY

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