24D2175522 CLIA NUMBER - MIDWEST GROUP LIVING INC

Laboratory Demographics

  • CLIA Code: 24D2175522
  • Facility Name: MIDWEST GROUP LIVING INC
  • Facility Address: 3552 1ST AVE S
    MINNEAPOLIS, MN
    ZIP 55408
  • Facility Phone: 952 457-3802
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: HESEN SHIRE
  • NPI Number: 1457837668
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 24D2175522
LAB Type Home Health Agency
Facility Name MIDWEST GROUP LIVING INC
Street 3552 1ST AVE S
City MINNEAPOLIS
State MN
ZIP 55408
Phone 952 457-3802
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/22/2023
Certificate Expiration Date 11/21/2025
Facility Type Home Health Agency
Lab Director HESEN SHIRE

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