24D2303689 CLIA NUMBER - PRAIRIECARE WOODBURY

Laboratory Demographics

  • CLIA Code: 24D2303689
  • Facility Name: PRAIRIECARE WOODBURY
  • Facility Address: 659 BIELENBERG DR
    WOODBURY, MN
    ZIP 55125
  • Facility Phone: 952 826-8476
  • Facility Type: Other - BEHAVIORAL HEALTH OUTPATI
  • Facility Type: Waiver
  • Lab Director: CHRISTOPHER WALL
  • NPI Number: 1043512593
  • Taxonomy: 106H00000X - Marriage & Family Therapist

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CLIA Record

Field Name Field Value
CLIA Number 24D2303689
LAB Type Other - BEHAVIORAL HEALTH OUTPATI
Facility Name PRAIRIECARE WOODBURY
Street 659 BIELENBERG DR
City WOODBURY
State MN
ZIP 55125
Phone 952 826-8476
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/30/2024
Certificate Expiration Date 4/29/2026
Facility Type Other - BEHAVIORAL HEALTH OUTPATI
Lab Director CHRISTOPHER WALL

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