24D2278624 CLIA NUMBER - IMED HOMECARE LLC

Laboratory Demographics

  • CLIA Code: 24D2278624
  • Facility Name: IMED HOMECARE LLC
  • Facility Address: 4309 WEST OLD SHAKOPEE RD
    BLOOMINGTON, MN
    ZIP 55437
  • Facility Phone: 612 730-4235
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: EVANS M. MOGAKA
  • NPI Number: 1477283026
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 24D2278624
LAB Type Assisted Living Facility
Facility Name IMED HOMECARE LLC
Street 4309 WEST OLD SHAKOPEE RD
City BLOOMINGTON
State MN
ZIP 55437
Phone 612 730-4235
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/21/2025
Certificate Expiration Date 3/20/2027
Facility Type Assisted Living Facility
Lab Director EVANS M. MOGAKA

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