CLIA lab
CLIA 24D1031567: Lakeside Memory Care
Plymouth, MN. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 24D1031567 belongs to Lakeside Memory Care in Plymouth, MN.
Certificate of Waiver, effective October 4, 2026, expires October 3, 2028.
Active in the CMS Provider of Services file posted October 16, 2026.
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
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Certificate
- Certificate type
- Certificate of Waiver
- Certificate effective
- October 4, 2026
- Certificate expiration
- October 3, 2028
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- October 4, 2004
- Facility type
- Assisted living facility
- Ownership (control type)
- Proprietary
- Lab classification
- CLIA laboratory
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 24D1031567
- Lab name
- Lakeside Memory Care
- Address
- 15855 22nd Avenue North, Plymouth, MN 55447
- Phone
- (763) 476-8200
- Fax
- (763) 476-5900
Annual test volume the lab reported
- Waived tests
- 5,000
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Other labs in Plymouth, MN
- Advocate House Assisted Living ServicesCertificate of Waiver, Assisted living facility24D2325784
- Allina Health Plymouth ClinicCertificate of Waiver, Community clinic24D0899825
- Amira Choice Plymouth LLCCertificate of Waiver, Assisted living facility24D2140663
- Anw West Health LaboratoryCertificate of Waiver, Ancillary test site24D2069845
- Anw West Health, IncCertificate of Accreditation, Ancillary test site24D0891602
- Any Lab Test NowCertificate of Waiver, Independent24D2021228
- Balanced Chiropractic LLCCertificate of Waiver, Other24D2179401
- Bayada Home Health Care IncCertificate of Waiver, Home health agency24D0983661
- Cub Pharmacy #1633Certificate of Waiver, Pharmacy24D1067672
- Cub Pharmacy #1650Certificate of Waiver, Pharmacy24D1067467
Related
Questions
What is the CLIA number for Lakeside Memory Care in Plymouth?
24D1031567, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Lakeside Memory Care hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 24D1031567 expire?
The CMS file lists October 3, 2028 as the certificate expiration date; the certificate took effect October 4, 2026.