24D2187643 CLIA NUMBER - PEACE HOMECARE SERVICES LLC

Laboratory Demographics

  • CLIA Code: 24D2187643
  • Facility Name: PEACE HOMECARE SERVICES LLC
  • Facility Address: 5127 53RD AVE N
    CRYSTAL, MN
    ZIP 55429
  • Facility Phone: 908 414-1849
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: PEACE M. KIBAARA
  • NPI Number: 1740826452
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 24D2187643
LAB Type Assisted Living Facility
Facility Name PEACE HOMECARE SERVICES LLC
Street 5127 53RD AVE N
City CRYSTAL
State MN
ZIP 55429
Phone 908 414-1849
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/6/2024
Certificate Expiration Date 7/5/2026
Facility Type Assisted Living Facility
Lab Director PEACE M. KIBAARA

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