24D2264138 CLIA NUMBER - MINNESOTA CLINICAL STUDY CENTER

Laboratory Demographics

CLIA Number: 24D2264138

Facility Name: MINNESOTA CLINICAL STUDY CENTER

Facility Address:
119 - 14TH STREET NW, SUITE 250
NEW BRIGHTON, MN
ZIP 55112
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Facility Phone Number: 763 571-4200

Facility Type: Other - PRIVATE RESEARCH CLINICAL

Certificate Type: Waiver

NPI Number: 1568503845

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	24D2264138
LAB Type	Other - PRIVATE RESEARCH CLINICAL
Facility Name	MINNESOTA CLINICAL STUDY CENTER
Street	119 - 14TH STREET NW, SUITE 250
City	NEW BRIGHTON
State	MN
ZIP	55112
Phone	763 571-4200
CertificateType	4
CertificateEffectiveDate	7/11/2022
CertificateExpirationDate	7/10/2024
FacilityType	Waiver

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