CLIA lab

CLIA 24D2293765: Fairview Maple Grove Ambulatory Surgery Center

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

CLIA number 24D2293765 belongs to Fairview Maple Grove Ambulatory Surgery Center in Maple Grove, MN.

Certificate of Waiver, effective November 14, 2025, expires November 13, 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
November 14, 2025
Certificate expiration
November 13, 2027
Status in the CMS file
Active (termination code 00)
Original participation date
November 14, 2023
Facility type
Ambulatory surgery center
Ownership (control type)
Private
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
24D2293765
Lab name
Fairview Maple Grove Ambulatory Surgery Center
Address
14500 99th Avenue North, Ste 500, Maple Grove, MN 55369
Phone
(763) 898-1000
Fax
(763) 898-1009

Annual test volume the lab reported

Waived tests
1,072

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 Fairview Maple Grove Ambulatory Surgery Center in Maple Grove?

24D2293765, per the CMS Provider of Services file posted October 16, 2026.

What CLIA certificate does Fairview Maple Grove Ambulatory Surgery Center hold?

A Certificate of Waiver, according to the CMS file.

When does CLIA 24D2293765 expire?

The CMS file lists November 13, 2027 as the certificate expiration date; the certificate took effect November 14, 2025.

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