24D2223377 CLIA NUMBER - VAIMAR SUITES LLC

Laboratory Demographics

  • CLIA Code: 24D2223377
  • Facility Name: VAIMAR SUITES LLC
  • Facility Address: 6050 68TH AVE N
    BROOKLYN PARK, MN
    ZIP 55429
  • Facility Phone: 952 221-7318
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: MARTIN S. MUMBUWA
  • NPI Number: 1609499664
  • Taxonomy: 3104A0630X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 24D2223377
LAB Type Assisted Living Facility
Facility Name VAIMAR SUITES LLC
Street 6050 68TH AVE N
City BROOKLYN PARK
State MN
ZIP 55429
Phone 952 221-7318
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/6/2025
Certificate Expiration Date 5/5/2027
Facility Type Assisted Living Facility
Lab Director MARTIN S. MUMBUWA

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