24D2193661 CLIA NUMBER - GUARDIAN HOSPICE MN LLC DBA MOMENTS HOSPICE

Laboratory Demographics

  • CLIA Code: 24D2193661
  • Facility Name: GUARDIAN HOSPICE MN LLC DBA MOMENTS HOSPICE
  • Facility Address: 820 LILAC DRIVE N SUITE 210
    GOLDEN VALLEY, MN
    ZIP 55422
  • Facility Phone: 763 205-3600
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: MARK STANNARD
  • NPI Number: 1053865659
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 24D2193661
LAB Type Hospice
Facility Name GUARDIAN HOSPICE MN LLC DBA MOMENTS HOSPICE
Street 820 LILAC DRIVE N SUITE 210
City GOLDEN VALLEY
State MN
ZIP 55422
Phone 763 205-3600
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/23/2024
Certificate Expiration Date 9/22/2026
Facility Type Hospice
Lab Director MARK STANNARD

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