24D2276305 CLIA NUMBER - PRIMEMED PLCC

Laboratory Demographics

  • CLIA Code: 24D2276305
  • Facility Name: PRIMEMED PLCC
  • Facility Address: 322 W LAKE STREET, SUITE 101
    MINNEAPOLIS, MN
    ZIP 55408
  • Facility Phone: 857 492-6395
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MOHAMED A. ADAN
  • NPI Number: 1396450953
  • Taxonomy: 261QM1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 24D2276305
LAB Type Physician Office
Facility Name PRIMEMED PLCC
Street 322 W LAKE STREET, SUITE 101
City MINNEAPOLIS
State MN
ZIP 55408
Phone 857 492-6395
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/7/2025
Certificate Expiration Date 2/6/2027
Facility Type Physician Office
Lab Director MOHAMED A. ADAN

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