CLIA Code Details

Clinical Laboratory Code : 24D1042492

PHOENIX RESIDENCE VIKING (INTERMEDIATE CARE FACILITY FOR MENTALLY RETARDED)

Clinical Laboratory Information

Similar CLIA Codes
CLIA Number 24D1042492
Clinical laboratory number
Lab Name PHOENIX RESIDENCE VIKING
Laboratory Name
Lab Type Intermediate Care Facility for Mentally Retarded
Laboratory Type
Certificate Type Waiver
Clinical laboratory certificate type

Contacts

Phone 651-294-2076
Laboratory telephone number
Fax 651-294-2077
Fax number of the provider.

Facility Location

Street Address 645 VIKING DRIVE EAST
Primary location adress line
City LITTLE CANADA
Primary location city name
State MN
Primary location state name
Zip 55117
Primary location postal code

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