24D2230068 CLIA NUMBER - GOOD CLINIC MN PLLC

Laboratory Demographics

  • CLIA Code: 24D2230068
  • Facility Name: GOOD CLINIC MN PLLC
  • Facility Address: 12900 TECHNOLOGY DR
    EDEN PRAIRIE, MN
    ZIP 55344
  • Facility Phone: 763 639-5327
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: KEVIN L. SMITH
  • NPI Number: 1003423252
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 24D2230068
LAB Type Practitioner Other
Facility Name GOOD CLINIC MN PLLC
Street 12900 TECHNOLOGY DR
City EDEN PRAIRIE
State MN
ZIP 55344
Phone 763 639-5327
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/20/2025
Certificate Expiration Date 7/19/2027
Facility Type Practitioner Other
Lab Director KEVIN L. SMITH

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