24D2318633 CLIA NUMBER - BOKA HAVEN INC

Laboratory Demographics

  • CLIA Code: 24D2318633
  • Facility Name: BOKA HAVEN INC
  • Facility Address: 5251 386TH STREET
    NORTH BRANCH, MN
    ZIP 55056
  • Facility Phone: 651 362-6340
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: ETTAFA BOKA
  • NPI Number: 1578318994
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 24D2318633
LAB Type Assisted Living Facility
Facility Name BOKA HAVEN INC
Street 5251 386TH STREET
City NORTH BRANCH
State MN
ZIP 55056
Phone 651 362-6340
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/14/2025
Certificate Expiration Date 2/13/2027
Facility Type Assisted Living Facility
Lab Director ETTAFA BOKA

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