24D2320151 CLIA NUMBER - LIFE CLINIC

Laboratory Demographics

  • CLIA Code: 24D2320151
  • Facility Name: LIFE CLINIC
  • Facility Address: 9200 BASS LAKE RD., SUITE 265
    NEW HOPE, MN
    ZIP 55428
  • Facility Phone: 651 237-3763
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: ISAAC A. ADEDIRAN
  • NPI Number: 1033927744
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 24D2320151
LAB Type Physician Office
Facility Name LIFE CLINIC
Street 9200 BASS LAKE RD., SUITE 265
City NEW HOPE
State MN
ZIP 55428
Phone 651 237-3763
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 3/13/2025
Certificate Expiration Date 3/12/2027
Facility Type Physician Office
Lab Director ISAAC A. ADEDIRAN

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