24D2199398 CLIA NUMBER - CHAM CLINIC LLC

Laboratory Demographics

  • CLIA Code: 24D2199398
  • Facility Name: CHAM CLINIC LLC
  • Facility Address: 7362 UNIVERSITY AVE NE STE 206
    FRIDLEY, MN
    ZIP 55432
  • Facility Phone: 612 889-9344
  • Facility Type: Other - CLINIC
  • Facility Type: Waiver
  • Lab Director: INAS R. MUHIDINE
  • NPI Number: 1871191403
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 24D2199398
LAB Type Other - CLINIC
Facility Name CHAM CLINIC LLC
Street 7362 UNIVERSITY AVE NE STE 206
City FRIDLEY
State MN
ZIP 55432
Phone 612 889-9344
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/9/2024
Certificate Expiration Date 11/8/2026
Facility Type Other - CLINIC
Lab Director INAS R. MUHIDINE

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