24D2268917 CLIA NUMBER - PRECIOUS HEALTH SERVICES LLC

Laboratory Demographics

  • CLIA Code: 24D2268917
  • Facility Name: PRECIOUS HEALTH SERVICES LLC
  • Facility Address: 1113 SUBURBAN AVE
    SAINT PAUL, MN
    ZIP 55106
  • Facility Phone: 612 461-8150
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: FARDOWSA ISMAIL
  • NPI Number: 1770239030
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 24D2268917
LAB Type Assisted Living Facility
Facility Name PRECIOUS HEALTH SERVICES LLC
Street 1113 SUBURBAN AVE
City SAINT PAUL
State MN
ZIP 55106
Phone 612 461-8150
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/20/2024
Certificate Expiration Date 9/19/2026
Facility Type Assisted Living Facility
Lab Director FARDOWSA ISMAIL

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