CLIA lab
CLIA 24D1091444: Shakopee Dakota Mystic Clinic
Prior Lake, MN. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 24D1091444 belongs to Shakopee Dakota Mystic Clinic in Prior Lake, MN.
Certificate of Compliance, effective April 16, 2025, expires April 15, 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 Compliance
- Certificate effective
- April 16, 2025
- Certificate expiration
- April 15, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- October 31, 2008
- Facility type
- Other
- Ownership (control type)
- Other
- Lab classification
- CLIA laboratory
- Directly affiliated labs
- 1
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 24D1091444
- Lab name
- Shakopee Dakota Mystic Clinic
- Address
- 15000 Mystic Lake Drive, Prior Lake, MN 55372
- Phone
- (952) 233-4204
- Fax
- (952) 233-4224
Annual test volume the lab reported
- Waived tests
- 2,500
- Other nonwaived tests
- 65
- Total
- 2,565
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Affiliated CLIA numbers
Other labs in Prior Lake, MN
- Alpha Women's CenterCertificate of Waiver, Other24D2100690
- Balanced Kids HealthCertificate of Waiver, Other24D2341489
- Community Home Health, IncCertificate of Waiver, Home health agency24D0892709
- Fairview Clinics Prior Lake ClinicCertificate of Accreditation, Physician office24D0907190
- Goldsmith Eye Care PCCertificate of Waiver, Physician office24D2164785
- Lakeside Family Eye CareCertificate of Waiver, Physician office24D2249464
- Living Hope Homes - Peaceful PinesCertificate of Waiver, Assisted living facility24D2300943
- Mdewakanton Public SafetyCertificate of Waiver, Ambulance24D1013651
- New Perspective Prior LakeCertificate of Waiver, Assisted living facility24D1015404
- Norbella Prior LakeCertificate of Waiver, Assisted living facility24D2233636
Related
Questions
What is the CLIA number for Shakopee Dakota Mystic Clinic in Prior Lake?
24D1091444, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Shakopee Dakota Mystic Clinic hold?
A Certificate of Compliance, according to the CMS file.
When does CLIA 24D1091444 expire?
The CMS file lists April 15, 2027 as the certificate expiration date; the certificate took effect April 16, 2025.