24D2216277 CLIA NUMBER - MIDWEST GROUP HOME LLC

Laboratory Demographics

  • CLIA Code: 24D2216277
  • Facility Name: MIDWEST GROUP HOME LLC
  • Facility Address: 4232 5TH STREET NE
    COLUMBIA HEIGHTS, MN
    ZIP 55421
  • Facility Phone: 612 205-4918
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: ABDULAHI HASHI
  • NPI Number: 1871193417
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 24D2216277
LAB Type Assisted Living Facility
Facility Name MIDWEST GROUP HOME LLC
Street 4232 5TH STREET NE
City COLUMBIA HEIGHTS
State MN
ZIP 55421
Phone 612 205-4918
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/11/2025
Certificate Expiration Date 3/10/2027
Facility Type Assisted Living Facility
Lab Director ABDULAHI HASHI

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