24D2298664 CLIA NUMBER - SUPERIOR HOSPICE INC

Laboratory Demographics

  • CLIA Code: 24D2298664
  • Facility Name: SUPERIOR HOSPICE INC
  • Facility Address: 800 BOONE AVE N STE 194
    GOLDEN VALLEY, MN
    ZIP 55427
  • Facility Phone: 763 277-8777
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: ANDREA KUSSMAUL
  • NPI Number: 1265211171
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 24D2298664
LAB Type Hospice
Facility Name SUPERIOR HOSPICE INC
Street 800 BOONE AVE N STE 194
City GOLDEN VALLEY
State MN
ZIP 55427
Phone 763 277-8777
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/6/2024
Certificate Expiration Date 2/5/2026
Facility Type Hospice
Lab Director ANDREA KUSSMAUL

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