24D2190801 CLIA NUMBER - PRISENDORF CARE, LLC DBA BRIGHTSTAR CARE OF PLYMOUTH

Laboratory Demographics

  • CLIA Code: 24D2190801
  • Facility Name: PRISENDORF CARE, LLC DBA BRIGHTSTAR CARE OF PLYMOUTH
  • Facility Address: 3030 HARBOR LANE, SUITE 124
    PLYMOUTH, MN
    ZIP 55447
  • Facility Phone: 763 432-5095
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: JUSTIN B. PRISENDORF
  • NPI Number: 1346713682
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 24D2190801
LAB Type Home Health Agency
Facility Name PRISENDORF CARE, LLC DBA BRIGHTSTAR CARE OF PLYMOUTH
Street 3030 HARBOR LANE, SUITE 124
City PLYMOUTH
State MN
ZIP 55447
Phone 763 432-5095
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/19/2024
Certificate Expiration Date 8/18/2026
Facility Type Home Health Agency
Lab Director JUSTIN B. PRISENDORF

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