CLIA lab

CLIA 24D2118649: Victoria Place

Shoreview, MN. Certificate and address details from the CMS Provider of Services file for clinical laboratories.

CLIA number 24D2118649 belongs to Victoria Place in Shoreview, MN.

Certificate of Waiver, effective September 13, 2026, expires September 12, 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
September 13, 2026
Certificate expiration
September 12, 2028
Status in the CMS file
Active (termination code 00)
Original participation date
September 13, 2016
Facility type
Other
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
24D2118649
Lab name
Victoria Place
Address
4408 Victoria Street, Shoreview, MN 55126
Phone
(763) 592-9414
Fax
(612) 662-8213

Annual test volume the lab reported

Waived tests
365

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 Victoria Place in Shoreview?

24D2118649, per the CMS Provider of Services file posted October 16, 2026.

What CLIA certificate does Victoria Place hold?

A Certificate of Waiver, according to the CMS file.

When does CLIA 24D2118649 expire?

The CMS file lists September 12, 2028 as the certificate expiration date; the certificate took effect September 13, 2026.

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