24D2228198 CLIA NUMBER - BLAINE EYE CLINIC

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CLIA Record

Field Name Field Value
CLIA Number 24D2228198
LAB Type Physician Office
Facility Name BLAINE EYE CLINIC
Street 12170 ABERDEEN ST NE
City BLAINE
State MN
ZIP 55449
Phone 763 757-7000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/23/2025
Certificate Expiration Date 6/22/2027
Facility Type Physician Office
Lab Director BREANN M. FORLITI

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