24D2173764 CLIA NUMBER - DAGAN WELLNESS LLC, DBA (DAGAN WELLNESS CLINIC)

Laboratory Demographics

  • CLIA Code: 24D2173764
  • Facility Name: DAGAN WELLNESS LLC, DBA (DAGAN WELLNESS CLINIC)
  • Facility Address: 11970 PORTLAND AVE S
    BURNSVILLE, MN
    ZIP 55337
  • Facility Phone: 507 271-6865
  • Facility Type: Other - PRIMARY CARE/URGENT CARE
  • Facility Type: Waiver
  • Lab Director: AYAN A. HASSAN
  • NPI Number: 1982065983
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 24D2173764
LAB Type Other - PRIMARY CARE/URGENT CARE
Facility Name DAGAN WELLNESS LLC, DBA (DAGAN WELLNESS CLINIC)
Street 11970 PORTLAND AVE S
City BURNSVILLE
State MN
ZIP 55337
Phone 507 271-6865
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/18/2023
Certificate Expiration Date 10/17/2025
Facility Type Other - PRIMARY CARE/URGENT CARE
Lab Director AYAN A. HASSAN

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