24D2309245 CLIA NUMBER - NEIGHBORHOOD HEALTHSOURCE - OUTREACH CLINIC

Laboratory Demographics

  • CLIA Code: 24D2309245
  • Facility Name: NEIGHBORHOOD HEALTHSOURCE - OUTREACH CLINIC
  • Facility Address: 342 13TH AVE NE
    MINNEAPOLIS, MN
    ZIP 55413
  • Facility Phone: 612 588-9411
  • Facility Type: Mobile Laboratory
  • Facility Type: Waiver
  • Lab Director: ROBIN J. BRESETTE
  • NPI Number: 1811934763
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 24D2309245
LAB Type Mobile Laboratory
Facility Name NEIGHBORHOOD HEALTHSOURCE - OUTREACH CLINIC
Street 342 13TH AVE NE
City MINNEAPOLIS
State MN
ZIP 55413
Phone 612 588-9411
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/12/2024
Certificate Expiration Date 8/11/2026
Facility Type Mobile Laboratory
Lab Director ROBIN J. BRESETTE

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