24D2238575 CLIA NUMBER - SOUTH ST PAUL PUBLIC SCHOOLS

Laboratory Demographics

CLIA Number: 24D2238575

Facility Name: SOUTH ST PAUL PUBLIC SCHOOLS

Facility Address:
104 5TH AVE S
SOUTH SAINT PAUL, MN
ZIP 55075
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Facility Phone Number: 651 457-9466

Facility Type: School/Student Health Service

Certificate Type: Waiver

NPI Number: 1720486996

Taxonomy: 284300000X - Special Hospital
A designation by the AHA of a hospital whose primary function of the institution is to provide diagnostic and treatment services for patients who have specified medical conditions, both surgical and nonsurgical.

CLIA Record

Field Name	Field Value
CLIA Number	24D2238575
LAB Type	School/Student Health Service
Facility Name	SOUTH ST PAUL PUBLIC SCHOOLS
Street	104 5TH AVE S
City	SOUTH SAINT PAUL
State	MN
ZIP	55075
Phone	651 457-9466
CertificateType	4
CertificateEffectiveDate	10/5/2023
CertificateExpirationDate	10/4/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024