24D2327248 CLIA NUMBER - MICHAELA RESIDENTIAL CARE LLC

Laboratory Demographics

  • CLIA Code: 24D2327248
  • Facility Name: MICHAELA RESIDENTIAL CARE LLC
  • Facility Address: 312 74TH AVE NORTH
    BROOKLYN PARK, MN
    ZIP 55444
  • Facility Phone: 952 688-1026
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: ESTER G. FARES
  • NPI Number: 1194518373
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 24D2327248
LAB Type Assisted Living Facility
Facility Name MICHAELA RESIDENTIAL CARE LLC
Street 312 74TH AVE NORTH
City BROOKLYN PARK
State MN
ZIP 55444
Phone 952 688-1026
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/18/2025
Certificate Expiration Date 7/17/2027
Facility Type Assisted Living Facility
Lab Director ESTER G. FARES

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