24D2244175 CLIA NUMBER - DIVINE PROVIDENCE HOMES, LLC

Laboratory Demographics

  • CLIA Code: 24D2244175
  • Facility Name: DIVINE PROVIDENCE HOMES, LLC
  • Facility Address: 1445 WINTHROP ST N
    SAINT PAUL, MN
    ZIP 55119
  • Facility Phone: 651 785-6880
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: KAREN MENDOZA
  • NPI Number: 1689246183
  • Taxonomy: 310400000X - Assisted Living Facility

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 24D2244175
LAB Type Assisted Living Facility
Facility Name DIVINE PROVIDENCE HOMES, LLC
Street 1445 WINTHROP ST N
City SAINT PAUL
State MN
ZIP 55119
Phone 651 785-6880
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/30/2023
Certificate Expiration Date 11/29/2025
Facility Type Assisted Living Facility
Lab Director KAREN MENDOZA

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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