24D2175242 CLIA NUMBER - SAMA HEALTHCARE

Laboratory Demographics

  • CLIA Code: 24D2175242
  • Facility Name: SAMA HEALTHCARE
  • Facility Address: 2639 NICOLLET AVE, SUITE 130
    MINNEAPOLIS, MN
    ZIP 55408
  • Facility Phone: 612 886-2686
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: LIBORIO L. LIRA
  • NPI Number: 1376906388
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 24D2175242
LAB Type Physician Office
Facility Name SAMA HEALTHCARE
Street 2639 NICOLLET AVE, SUITE 130
City MINNEAPOLIS
State MN
ZIP 55408
Phone 612 886-2686
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/19/2023
Certificate Expiration Date 11/18/2025
Facility Type Physician Office
Lab Director LIBORIO L. LIRA

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