24D2241174 CLIA NUMBER - KEY WELLNESS, PLLC

Laboratory Demographics

  • CLIA Code: 24D2241174
  • Facility Name: KEY WELLNESS, PLLC
  • Facility Address: 35752 ALLEN AVE
    CROSS LAKE, MN
    ZIP 56442
  • Facility Phone: 218 692-5397
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: KELLY M. VANVICKLE
  • NPI Number: 1962175893
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 24D2241174
LAB Type Practitioner Other
Facility Name KEY WELLNESS, PLLC
Street 35752 ALLEN AVE
City CROSS LAKE
State MN
ZIP 56442
Phone 218 692-5397
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/26/2023
Certificate Expiration Date 10/25/2025
Facility Type Practitioner Other
Lab Director KELLY M. VANVICKLE

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