CLIA lab
CLIA 24D2112635: Park Nicollet Surgery Center
Maple Grove, MN. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 24D2112635 belongs to Park Nicollet Surgery Center in Maple Grove, MN.
Certificate of Waiver, effective May 4, 2026, expires May 3, 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
- May 4, 2026
- Certificate expiration
- May 3, 2028
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- May 4, 2016
- Facility type
- Ambulatory surgery center
- Ownership (control type)
- Other
- 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
- 24D2112635
- Lab name
- Park Nicollet Surgery Center
- Address
- 15800 95th Ave North, Maple Grove, MN 55369
- Phone
- (952) 977-1052
Annual test volume the lab reported
- Waived tests
- 1,200
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
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 Surgery Center in Maple Grove?
24D2112635, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Park Nicollet Surgery Center hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 24D2112635 expire?
The CMS file lists May 3, 2028 as the certificate expiration date; the certificate took effect May 4, 2026.