24D2265768 CLIA NUMBER - VALLEY MEDICAL AND WELLNESS

Laboratory Demographics

CLIA Number: 24D2265768

Facility Name: VALLEY MEDICAL AND WELLNESS

Facility Address:
14440 28TH PL N
PLYMOUTH, MN
ZIP 55447
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Facility Phone Number: 612 444-3000

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1720616741

Taxonomy: 246RM2200X - Technician, Pathology

CLIA Record

Field Name	Field Value
CLIA Number	24D2265768
LAB Type	Physician Office
Facility Name	VALLEY MEDICAL AND WELLNESS
Street	14440 28TH PL N
City	PLYMOUTH
State	MN
ZIP	55447
Phone	612 444-3000
CertificateType	4
CertificateEffectiveDate	8/2/2022
CertificateExpirationDate	8/1/2024
FacilityType	Waiver

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