24D2267954 CLIA NUMBER - COMMUNITY MEDICAL SERVICES - MINNEAPOLIS ON BROADWAY

Laboratory Demographics

  • CLIA Code: 24D2267954
  • Facility Name: COMMUNITY MEDICAL SERVICES - MINNEAPOLIS ON BROADWAY
  • Facility Address: 1020 WEST BROADWAY
    MINNEAPOLIS, MN
    ZIP 55411
  • Facility Phone: 612 895-3850
  • Facility Type: Other - OUTPATIENT TREATMENT PROG
  • Facility Type: Waiver
  • Lab Director: JUSTIN ABEYTA
  • NPI Number: 1396245387
  • Taxonomy: 251B00000X - Case Management

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 24D2267954
LAB Type Other - OUTPATIENT TREATMENT PROG
Facility Name COMMUNITY MEDICAL SERVICES - MINNEAPOLIS ON BROADWAY
Street 1020 WEST BROADWAY
City MINNEAPOLIS
State MN
ZIP 55411
Phone 612 895-3850
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/2/2024
Certificate Expiration Date 9/1/2026
Facility Type Other - OUTPATIENT TREATMENT PROG
Lab Director JUSTIN ABEYTA

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