24D2184031 CLIA NUMBER - GERITOM MED, INC

Laboratory Demographics

  • CLIA Code: 24D2184031
  • Facility Name: GERITOM MED, INC
  • Facility Address: 10501 FLORIDA AVE S
    BLOOMINGTON, MN
    ZIP 55438
  • Facility Phone: 952 854-1190
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JASON R. WACHTL
  • NPI Number: 1285621193
  • Taxonomy: 3336L0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D2184031
LAB Type Pharmacy
Facility Name GERITOM MED, INC
Street 10501 FLORIDA AVE S
City BLOOMINGTON
State MN
ZIP 55438
Phone 952 854-1190
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/14/2024
Certificate Expiration Date 5/13/2026
Facility Type Pharmacy
Lab Director JASON R. WACHTL

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