CLIA lab

CLIA 24D2211216: Havenwood of Maple Grove

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

CLIA number 24D2211216 belongs to Havenwood of Maple Grove in Maple Grove, MN.

Certificate of Waiver, effective January 26, 2025, expires January 25, 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
January 26, 2025
Certificate expiration
January 25, 2027
Status in the CMS file
Active (termination code 00)
Original participation date
January 26, 2021
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
24D2211216
Lab name
Havenwood of Maple Grove
Address
18695 73rd Avenue North, Maple Grove, MN 55311
Phone
(612) 800-0405
Fax
(763) 363-8664

Annual test volume the lab reported

Waived tests
4,500

Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.

Other labs in Maple Grove, MN

Related

Questions

What is the CLIA number for Havenwood of Maple Grove in Maple Grove?

24D2211216, per the CMS Provider of Services file posted October 16, 2026.

What CLIA certificate does Havenwood of Maple Grove hold?

A Certificate of Waiver, according to the CMS file.

When does CLIA 24D2211216 expire?

The CMS file lists January 25, 2027 as the certificate expiration date; the certificate took effect January 26, 2025.

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