CLIA lab
CLIA 24D2053966: Premise Health of Minnesota Medical, PC
Maple Grove, MN. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 24D2053966 belongs to Premise Health of Minnesota Medical, PC in Maple Grove, MN.
Certificate of Waiver, effective September 7, 2025, expires September 6, 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
- September 7, 2025
- Certificate expiration
- September 6, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- February 11, 2013
- Facility type
- Physician office
- 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
- 24D2053966
- Lab name
- Premise Health of Minnesota Medical, PC
- Address
- 13998 Maple Knoll Way, Suite 101, Lower Level, Maple Grove, MN 55369
- Phone
- (651) 683-2434
- Fax
- (763) 567-1370
Annual test volume the lab reported
- Waived tests
- 300
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
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- Arbor Lakes Senior LivingCertificate of Waiver, Assisted living facility24D2015826
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- Arthritis & Rheumatology Consultants PACertificate of Compliance, Physician office24D2061345
Related
Questions
What is the CLIA number for Premise Health of Minnesota Medical, PC in Maple Grove?
24D2053966, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Premise Health of Minnesota Medical, PC hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 24D2053966 expire?
The CMS file lists September 6, 2027 as the certificate expiration date; the certificate took effect September 7, 2025.