24D2274074 CLIA NUMBER - POINTCARE MEDICAL CENTER

Laboratory Demographics

CLIA Number: 24D2274074

Facility Name: POINTCARE MEDICAL CENTER

Facility Address:
4727 HIAWATHA AVE
MINNEAPOLIS, MN
ZIP 55406
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Facility Phone Number: 612 208-0985

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1689306763

Taxonomy: 363LP2300X - Nurse Practitioner

CLIA Record

Field Name	Field Value
CLIA Number	24D2274074
LAB Type	Physician Office
Facility Name	POINTCARE MEDICAL CENTER
Street	4727 HIAWATHA AVE
City	MINNEAPOLIS
State	MN
ZIP	55406
Phone	612 208-0985
CertificateType	4
CertificateEffectiveDate	12/23/2022
CertificateExpirationDate	12/22/2024
FacilityType	Waiver

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