24D2280302 CLIA NUMBER - PRIMARY ENT

Laboratory Demographics

  • CLIA Code: 24D2280302
  • Facility Name: PRIMARY ENT
  • Facility Address: 14020 HWY 13 #350
    SAVAGE, MN
    ZIP 55378
  • Facility Phone: (952) 395-2500
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MELANIE L. JOHNSON
  • NPI Number: 1386374593
  • Taxonomy: 207YX0905X - Otolaryngology

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CLIA Record

Field Name Field Value
CLIA Number 24D2280302
LAB Type Physician Office
Facility Name PRIMARY ENT
Street 14020 HWY 13 #350
City SAVAGE
State MN
ZIP 55378
Phone 9523952500
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/18/2025
Certificate Expiration Date 4/17/2027
Facility Type Physician Office
Lab Director MELANIE L. JOHNSON

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This page was last updated on: 5/18/2026