24D2178417 CLIA NUMBER - NEW KINGDOM HEALTHCARE

Laboratory Demographics

  • CLIA Code: 24D2178417
  • Facility Name: NEW KINGDOM HEALTHCARE
  • Facility Address: 10904 57TH ST NE SUITE 106
    ALBERTVILLE, MN
    ZIP 55301
  • Facility Phone: 952 999-0333
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR ROBERT K. ZAJAC
  • NPI Number: 1760816045
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 24D2178417
LAB Type Physician Office
Facility Name NEW KINGDOM HEALTHCARE
Street 10904 57TH ST NE SUITE 106
City ALBERTVILLE
State MN
ZIP 55301
Phone 952 999-0333
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/3/2024
Certificate Expiration Date 2/2/2026
Facility Type Physician Office
Lab Director DR ROBERT K. ZAJAC

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