24D2312263 CLIA NUMBER - RIDGEVIEW WACONIA SPECIALTY CLINIC URGENT CARE

Laboratory Demographics

  • CLIA Code: 24D2312263
  • Facility Name: RIDGEVIEW WACONIA SPECIALTY CLINIC URGENT CARE
  • Facility Address: 560 S MAPLE STREET SUITE 30
    WACONIA, MN
    ZIP 55387
  • Facility Phone: 952 442-1774
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: MARY FARLOW
  • NPI Number: 1538211040
  • Taxonomy: 207Y00000X - Otolaryngology

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CLIA Record

Field Name Field Value
CLIA Number 24D2312263
LAB Type Community Clinic
Facility Name RIDGEVIEW WACONIA SPECIALTY CLINIC URGENT CARE
Street 560 S MAPLE STREET SUITE 30
City WACONIA
State MN
ZIP 55387
Phone 952 442-1774
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/8/2024
Certificate Expiration Date 10/7/2026
Facility Type Community Clinic
Lab Director MARY FARLOW

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