24D2326605 CLIA NUMBER - TRUSTED HAVEN ASSISTED LIVING LLC

Laboratory Demographics

  • CLIA Code: 24D2326605
  • Facility Name: TRUSTED HAVEN ASSISTED LIVING LLC
  • Facility Address: 5754 HUMBOLDT AVE N
    BROOKLYN CENTER, MN
    ZIP 55430
  • Facility Phone: 612 447-8396
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: CHINEDU AGBONGHAI
  • NPI Number: 1487476503
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 24D2326605
LAB Type Assisted Living Facility
Facility Name TRUSTED HAVEN ASSISTED LIVING LLC
Street 5754 HUMBOLDT AVE N
City BROOKLYN CENTER
State MN
ZIP 55430
Phone 612 447-8396
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/8/2025
Certificate Expiration Date 7/7/2027
Facility Type Assisted Living Facility
Lab Director CHINEDU AGBONGHAI

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