24D2207229 CLIA NUMBER - SUNSHINE GROUP HOME LLC

Laboratory Demographics

  • CLIA Code: 24D2207229
  • Facility Name: SUNSHINE GROUP HOME LLC
  • Facility Address: 125 MAGNOLIA AVE W
    SAINT PAUL, MN
    ZIP 55117
  • Facility Phone: 612 447-7258
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: MARWAN M. SALEM
  • NPI Number: 1295348381
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 24D2207229
LAB Type Assisted Living Facility
Facility Name SUNSHINE GROUP HOME LLC
Street 125 MAGNOLIA AVE W
City SAINT PAUL
State MN
ZIP 55117
Phone 612 447-7258
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/26/2024
Certificate Expiration Date 12/25/2026
Facility Type Assisted Living Facility
Lab Director MARWAN M. SALEM

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