24D2270973 CLIA NUMBER - VICTORY HOMES

Laboratory Demographics

  • CLIA Code: 24D2270973
  • Facility Name: VICTORY HOMES
  • Facility Address: 7917 PERRY AVE N
    BROOKLYN PARK, MN
    ZIP 55443
  • Facility Phone: 763 321-1278
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: BALLAH DWAPU
  • NPI Number: 1770181679
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 24D2270973
LAB Type Assisted Living Facility
Facility Name VICTORY HOMES
Street 7917 PERRY AVE N
City BROOKLYN PARK
State MN
ZIP 55443
Phone 763 321-1278
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/25/2024
Certificate Expiration Date 10/24/2026
Facility Type Assisted Living Facility
Lab Director BALLAH DWAPU

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