CLIA Code Details

Clinical Laboratory Code : 24D1042487

PHOENIX RESIDENCE LUDDEN (INTERMEDIATE CARE FACILITY FOR MENTALLY RETARDED)

Clinical Laboratory Information

Similar CLIA Codes
CLIA Number 24D1042487
Clinical laboratory number
Lab Name PHOENIX RESIDENCE LUDDEN
Laboratory Name
Lab Type Intermediate Care Facility for Mentally Retarded
Laboratory Type
Certificate Type Waiver
Clinical laboratory certificate type

Contacts

Phone 763-398-3812
Laboratory telephone number
Fax 763-398-3813
Fax number of the provider.

Facility Location

Street Address 7177 LONG LAKE ROAD
Primary location adress line
City MOUNDS VIEW
Primary location city name
State MN
Primary location state name
Zip 55112
Primary location postal code

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