CLIA lab
CLIA 24D2202396: Boulder Ponds Senior Living
Lake Elmo, MN. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 24D2202396 belongs to Boulder Ponds Senior Living in Lake Elmo, MN.
Certificate of Waiver, effective November 26, 2024, expires November 25, 2026.
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
Run it in Rivvi
Map your lab's test names to LOINC codes
Open in RivviFree to start. Opens Rivvi, the AI workspace for healthcare teams.
Certificate
- Certificate type
- Certificate of Waiver
- Certificate effective
- November 26, 2024
- Certificate expiration
- November 25, 2026
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- November 26, 2020
- Facility type
- Assisted living facility
- 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
- 24D2202396
- Lab name
- Boulder Ponds Senior Living
- Address
- 192 Jade Trail North, Lake Elmo, MN 55042
- Phone
- (612) 431-2430
Annual test volume the lab reported
- Waived tests
- 100
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Other labs in Lake Elmo, MN
Related
Questions
What is the CLIA number for Boulder Ponds Senior Living in Lake Elmo?
24D2202396, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Boulder Ponds Senior Living hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 24D2202396 expire?
The CMS file lists November 25, 2026 as the certificate expiration date; the certificate took effect November 26, 2024.