24D2313538 CLIA NUMBER - NESTLE CARE LLC

Laboratory Demographics

  • CLIA Code: 24D2313538
  • Facility Name: NESTLE CARE LLC
  • Facility Address: 6019 WEST 39TH STREET
    SAINT LOUIS PARK, MN
    ZIP 55416
  • Facility Phone: 952 807-9194
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: MARYAN A. ISSE
  • NPI Number: 1861212136
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 24D2313538
LAB Type Assisted Living Facility
Facility Name NESTLE CARE LLC
Street 6019 WEST 39TH STREET
City SAINT LOUIS PARK
State MN
ZIP 55416
Phone 952 807-9194
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/1/2024
Certificate Expiration Date 10/31/2026
Facility Type Assisted Living Facility
Lab Director MARYAN A. ISSE

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