24D2281362 CLIA NUMBER - GOLDEN MAPLE HOME

Laboratory Demographics

  • CLIA Code: 24D2281362
  • Facility Name: GOLDEN MAPLE HOME
  • Facility Address: 13613 WASHBURN AVE S
    BURNSVILLE, MN
    ZIP 55337
  • Facility Phone: 952 393-3690
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: CAROL FILLMORE
  • NPI Number: 1356701379
  • Taxonomy: 311Z00000X - Custodial Care Facility

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CLIA Record

Field Name Field Value
CLIA Number 24D2281362
LAB Type Assisted Living Facility
Facility Name GOLDEN MAPLE HOME
Street 13613 WASHBURN AVE S
City BURNSVILLE
State MN
ZIP 55337
Phone 952 393-3690
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/5/2025
Certificate Expiration Date 5/4/2027
Facility Type Assisted Living Facility
Lab Director CAROL FILLMORE

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