CLIA lab
CLIA 24D2049447: Park Nicollet Clinic - Champlin
Champlin, MN. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 24D2049447 belongs to Park Nicollet Clinic - Champlin in Champlin, MN.
Certificate of Waiver, effective August 28, 2025, expires August 27, 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
- August 28, 2025
- Certificate expiration
- August 27, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- November 6, 2012
- Facility type
- Physician office
- Ownership (control type)
- Other
- 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
- 24D2049447
- Lab name
- Park Nicollet Clinic - Champlin
- Address
- 12142 Business Park Blvd N, Champlin, MN 55316
- Phone
- (952) 977-0503
- Fax
- (952) 977-0509
Annual test volume the lab reported
- Waived tests
- 1,429
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Affiliated CLIA numbers
Other labs in Champlin, MN
- Alliance Assisted Living Services LLCCertificate of Waiver, Assisted living facility24D2336149
- Allina Health Champlin ClinicCertificate of Accreditation, Physician office24D0400093
- Amira Choice Champlin LLCCertificate of Waiver, Assisted living facility24D1028387
- Betty Care Services LLCCertificate of Waiver, Assisted living facility24D2289981
- Charity Care IncCertificate of Waiver, Home health agency24D2187482
- Cub Pharmacy #1643Certificate of Waiver, Pharmacy24D1067659
- Delight Home Healthcare, LLCCertificate of Waiver, Assisted living facility24D2233631
- Encore at ChamplinCertificate of Waiver, Assisted living facility24D1068777
- Everlasting Care HomesCertificate of Waiver, Assisted living facility24D2296035
- Family Support Home Care LLCCertificate of Waiver, Home health agency24D2316216
Related
Questions
What is the CLIA number for Park Nicollet Clinic - Champlin in Champlin?
24D2049447, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Park Nicollet Clinic - Champlin hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 24D2049447 expire?
The CMS file lists August 27, 2027 as the certificate expiration date; the certificate took effect August 28, 2025.