24D2317252 CLIA NUMBER - LIBERTY CARE LLC

Laboratory Demographics

  • CLIA Code: 24D2317252
  • Facility Name: LIBERTY CARE LLC
  • Facility Address: 10820 DIRECT RIVER DR NW
    COON RAPIDS, MN
    ZIP 55433
  • Facility Phone: 651 354-9760
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: OMOWUNMI BAYO
  • NPI Number: 1902641038
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 24D2317252
LAB Type Assisted Living Facility
Facility Name LIBERTY CARE LLC
Street 10820 DIRECT RIVER DR NW
City COON RAPIDS
State MN
ZIP 55433
Phone 651 354-9760
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/21/2025
Certificate Expiration Date 1/20/2027
Facility Type Assisted Living Facility
Lab Director OMOWUNMI BAYO

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