24D2184144 CLIA NUMBER - HAZEL SENIOR LIVING LLC

Laboratory Demographics

  • CLIA Code: 24D2184144
  • Facility Name: HAZEL SENIOR LIVING LLC
  • Facility Address: 1109 HAZEL ST N
    SAINT PAUL, MN
    ZIP 55119
  • Facility Phone: 651 343-0080
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: MAI S. VANG
  • NPI Number: 1770106205
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 24D2184144
LAB Type Assisted Living Facility
Facility Name HAZEL SENIOR LIVING LLC
Street 1109 HAZEL ST N
City SAINT PAUL
State MN
ZIP 55119
Phone 651 343-0080
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/15/2024
Certificate Expiration Date 5/14/2026
Facility Type Assisted Living Facility
Lab Director MAI S. VANG

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