CLIA lab
CLIA 24D2019254: Hennepin County Adult Correctional Facility -
Plymouth, MN. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 24D2019254 belongs to Hennepin County Adult Correctional Facility - in Plymouth, MN.
Certificate of Waiver, effective January 25, 2025, expires January 24, 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
- January 25, 2025
- Certificate expiration
- January 24, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- January 25, 2011
- Facility type
- Prison
- 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
- 24D2019254
- Lab name
- Hennepin County Adult Correctional Facility -
- Additional name
- Mens
- Address
- 1145 Shenandoah Lane, Plymouth, MN 55447
- Phone
- (612) 255-0628
- Fax
- (612) 255-0647
Annual test volume the lab reported
- Waived tests
- 9,480
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 Hennepin County Adult Correctional Facility - in Plymouth?
24D2019254, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Hennepin County Adult Correctional Facility - hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 24D2019254 expire?
The CMS file lists January 24, 2027 as the certificate expiration date; the certificate took effect January 25, 2025.