CLIA lab

CLIA 24D1077038: Suburban Imaging Maple Grove

Maple Grove, MN. Certificate and address details from the CMS Provider of Services file for clinical laboratories.

CLIA number 24D1077038 belongs to Suburban Imaging Maple Grove in Maple Grove, MN.

Certificate of Waiver, effective July 17, 2025, expires July 16, 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
July 17, 2025
Certificate expiration
July 16, 2027
Status in the CMS file
Active (termination code 00)
Original participation date
November 29, 2007
Facility type
Other
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
24D1077038
Lab name
Suburban Imaging Maple Grove
Address
12000 Elm Creek Blvd Suite 310, Maple Grove, MN 55369
Phone
(763) 416-7888
Fax
(763) 416-7889

Annual test volume the lab reported

Waived tests
100

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 Suburban Imaging Maple Grove in Maple Grove?

24D1077038, per the CMS Provider of Services file posted October 16, 2026.

What CLIA certificate does Suburban Imaging Maple Grove hold?

A Certificate of Waiver, according to the CMS file.

When does CLIA 24D1077038 expire?

The CMS file lists July 16, 2027 as the certificate expiration date; the certificate took effect July 17, 2025.

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