CLIA lab
CLIA 24D1042487: Phoenix Residence Ludden
Mounds View, MN. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 24D1042487 belongs to Phoenix Residence Ludden in Mounds View, MN.
Certificate of Waiver, effective April 12, 2026, expires April 11, 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
- April 12, 2026
- Certificate expiration
- April 11, 2028
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- June 30, 2005
- Facility type
- Intermediate care facility for individuals with intellectual disabilities
- Ownership (control type)
- Private
- 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
- 24D1042487
- Lab name
- Phoenix Residence Ludden
- Address
- 7177 Long Lake Road, Mounds View, MN 55112
- Phone
- (763) 398-3812
- Fax
- (763) 398-3813
Annual test volume the lab reported
- Waived tests
- 12
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
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Related
Questions
What is the CLIA number for Phoenix Residence Ludden in Mounds View?
24D1042487, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Phoenix Residence Ludden hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 24D1042487 expire?
The CMS file lists April 11, 2028 as the certificate expiration date; the certificate took effect April 12, 2026.