24D2262304 CLIA NUMBER - TRISTAR HOME CARE LLC

Laboratory Demographics

CLIA Number: 24D2262304

Facility Name: TRISTAR HOME CARE LLC

Facility Address:
3000 80TH AVE N
BROOKLYN PARK, MN
ZIP 55444
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Facility Phone Number: 763 415-5471

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1649779828

Taxonomy: 310400000X - Assisted Living Facility
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

CLIA Record

Field Name	Field Value
CLIA Number	24D2262304
LAB Type	Assisted Living Facility
Facility Name	TRISTAR HOME CARE LLC
Street	3000 80TH AVE N
City	BROOKLYN PARK
State	MN
ZIP	55444
Phone	763 415-5471
CertificateType	4
CertificateEffectiveDate	6/13/2022
CertificateExpirationDate	6/12/2024
FacilityType	Waiver

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