CLIA lab
CLIA 24D2040494: Park Nicollet Clinic - Maple Grove OB
Maple Grove, MN. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 24D2040494 belongs to Park Nicollet Clinic - Maple Grove OB in Maple Grove, MN.
Certificate of Waiver, effective August 1, 2026, expires July 31, 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
- August 1, 2026
- Certificate expiration
- July 31, 2028
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- May 2, 2012
- Facility type
- Ancillary test site
- Ownership (control type)
- Private
- Lab classification
- CLIA laboratory
- Directly affiliated labs
- 2
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 24D2040494
- Lab name
- Park Nicollet Clinic - Maple Grove OB
- Address
- 9855 Hospital Drive Suite 275, Maple Grove, MN 55369
- Phone
- (952) 977-0220
Annual test volume the lab reported
- Waived tests
- 2,000
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Affiliated CLIA numbers
Other labs in Maple Grove, MN
- 1 on 1 Comprehensive Healthcare SolutionCertificate of Waiver, Assisted living facility24D2280150
- Acr MagnoliaCertificate of Waiver, Other24D1053133
- Advent Maple GroveCertificate of Waiver, Physician office24D2297819
- Agape Home Care ServicesCertificate of Waiver, Assisted living facility24D2315635
- Alliance Assisted Living Services LLCCertificate of Waiver, Assisted living facility24D2336152
- Allina Health Maple GroveCertificate of Waiver, Community clinic24D0400724
- Almara Women's Health Ogi-MgCertificate for Provider-Performed Microscopy Procedures, Physician office24D0900330
- Arbor Lakes Senior LivingCertificate of Waiver, Assisted living facility24D2015826
- Arbor Lakes Senior Living IICertificate of Waiver, Assisted living facility24D2230076
- Arthritis & Rheumatology Consultants PACertificate of Compliance, Physician office24D2061345
Related
Questions
What is the CLIA number for Park Nicollet Clinic - Maple Grove OB in Maple Grove?
24D2040494, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Park Nicollet Clinic - Maple Grove OB hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 24D2040494 expire?
The CMS file lists July 31, 2028 as the certificate expiration date; the certificate took effect August 1, 2026.