24D2288544 CLIA NUMBER - LIFEWAY HEALTH & WELLNESS

Laboratory Demographics

  • CLIA Code: 24D2288544
  • Facility Name: LIFEWAY HEALTH & WELLNESS
  • Facility Address: 6469 SYCAMORE CT N
    MAPLE GROVE, MN
    ZIP 55369
  • Facility Phone: 763 276-9443
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: STACY A. WOODARD
  • NPI Number: 1598443723
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 24D2288544
LAB Type Practitioner Other
Facility Name LIFEWAY HEALTH & WELLNESS
Street 6469 SYCAMORE CT N
City MAPLE GROVE
State MN
ZIP 55369
Phone 763 276-9443
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/28/2025
Certificate Expiration Date 8/27/2027
Facility Type Practitioner Other
Lab Director STACY A. WOODARD

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