CLIA lab
CLIA 24D1077028: Premise Health of Minnesota Medical, PC
Fridley, MN. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 24D1077028 belongs to Premise Health of Minnesota Medical, PC in Fridley, MN.
Certificate of Waiver, effective November 29, 2025, expires November 28, 2027.
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
- November 29, 2025
- Certificate expiration
- November 28, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- November 29, 2007
- Facility type
- Physician office
- 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
- 24D1077028
- Lab name
- Premise Health of Minnesota Medical, PC
- Additional name
- DBA Cummins Health Center - Fridley
- Address
- Power Generation Plant, 1400 73rd Ave NE, Fridley, MN 55432
- Phone
- (763) 574-5740
- Fax
- (763) 528-7234
Annual test volume the lab reported
- Waived tests
- 200
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
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- Cham Clinic LLCCertificate of Waiver, Other24D2199398
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- Child and Teen Medical CenterCertificate of Accreditation, Physician office24D0402828
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Related
Questions
What is the CLIA number for Premise Health of Minnesota Medical, PC in Fridley?
24D1077028, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Premise Health of Minnesota Medical, PC hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 24D1077028 expire?
The CMS file lists November 28, 2027 as the certificate expiration date; the certificate took effect November 29, 2025.