24D2296701 CLIA NUMBER - PRIME HOME SERVICES, LLC

Laboratory Demographics

  • CLIA Code: 24D2296701
  • Facility Name: PRIME HOME SERVICES, LLC
  • Facility Address: 198 E 95TH STREET CIRCLE
    BLOOMINGTON, MN
    ZIP 55420
  • Facility Phone: 612 807-7228
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: KEYSI J. YUSUF
  • NPI Number: 1902589401
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 24D2296701
LAB Type Assisted Living Facility
Facility Name PRIME HOME SERVICES, LLC
Street 198 E 95TH STREET CIRCLE
City BLOOMINGTON
State MN
ZIP 55420
Phone 612 807-7228
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/4/2024
Certificate Expiration Date 1/3/2026
Facility Type Assisted Living Facility
Lab Director KEYSI J. YUSUF

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