24D2189175 CLIA NUMBER - ADEQUATE HOME CARE LLC

Laboratory Demographics

  • CLIA Code: 24D2189175
  • Facility Name: ADEQUATE HOME CARE LLC
  • Facility Address: 10255 MADISON ST NE
    BLAINE, MN
    ZIP 55434
  • Facility Phone: 651 367-9906
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: MOUNIR AYOUB
  • NPI Number: 1134742208
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 24D2189175
LAB Type Assisted Living Facility
Facility Name ADEQUATE HOME CARE LLC
Street 10255 MADISON ST NE
City BLAINE
State MN
ZIP 55434
Phone 651 367-9906
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/28/2024
Certificate Expiration Date 7/27/2026
Facility Type Assisted Living Facility
Lab Director MOUNIR AYOUB

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This page was last updated on: 6/4/2025