GENOA HEALTHCARE CLINICAL LABORATORY LLC (NPI# 1548564511) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548564511 |
| Entity Type | Organization |
| Organization Name | GENOA HEALTHCARE CLINICAL LABORATORY LLC |
| Other Organization Name | GENOA HEALTHCARE |
| Practice Address |
3101 Old Highway 8 Suite 203-a Roseville MN 55113-1072 |
| Mailing Address |
18300 Cascade Ave S Suite 251 Tukwila WA 98188-4746 |
| Practice Telephone | 9523880400 |
| Practice Fax Number | 6513041902 |
| Mailing Telephone | 4256795692 |
| Mailing Fax Number | 2062750114 |
| Enumeration Date | 2011-01-05 |
| Last Update Date | 2011-07-22 |
| Authorized Official Name | MR. PHILLIP RAYMOND STROETZ (LABORATORY DIRECTOR) |
| Authorized Official Telephone | 6519174029 |
| Authorized Official Credential | MT ASCP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 291U00000X | Clinical Medical Laboratory | Laboratories |
| Other Name | Type Code |
|---|---|
| GENOA HEALTHCARE | Doing Business As Name - Organization |
| Street Address |
3101 OLD HIGHWAY 8 SUITE 203-A |
| City | ROSEVILLE |
| State | MN |
| Zip Code | 55113-1072 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407902307 | Michael James Petersen | Dentist | 3101 Old Highway 8, Suite #303, Roseville, MN 55113-1072 | 2007-01-25 |
| 1083163745 | Andrya Dieter, Psyd, Lp, LLC | Community/Behavioral Health | 3101 Old Highway 8, Suite 304b, Roseville, MN 55113-1072 | 2016-09-22 |
| 1447620950 | Nicole Klersy-mohr | Chiropractor | 3101 Old Highway 8, 300, Roseville, MN 55113-1072 | 2015-09-28 |
| 1548639586 | Perfect Touch Massage & Chiropractic, Ltd | Chiropractor | 3101 Old Highway 8, Suite 300, Roseville, MN 55113-1072 | 2015-09-21 |
| 1528384484 | Keumhwa Choi | Acupuncturist | 3101 Old Highway 8, Suite Number 104, Roseville, MN 55113-1072 | 2010-04-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396384376 | Zachary Mattson | Physician Assistant | Regus Coworking Space 2355 Highway 36 West, Suite 400, Office #427, Roseville, MN 55113 | 2019-12-23 |
| 1467010330 | Ahmed Issa | Student in an Organized Health Care Education/Training Program | 1550 Larpenteur Ave W, Apt 235, St Paul, MN 55113 | 2019-06-05 |
| 1821653833 | Suite Living Senior Care of Little Canada | Assisted Living Facility | 2740 Rice Street, Little Canada, MN 55113 | 2019-05-06 |
| 1902370505 | Diverse Assessments and Treatment, LLC | Psychologist | 1935 Cty Rd B2 W Ste 270, Roseville, MN 55113 | 2019-01-16 |
| 1588138473 | Applewood Home Health Care, LLC | Home Health | 2021 E Hennepin Avenue # 402-1, Minneapolis, MN 55113 | 2019-01-14 |
| 1699251520 | Optum Infusion Services 500, Inc. | Durable Medical Equipment & Medical Supplies | 2685 Patton Rd, Roseville, MN 55113 | 2018-07-13 |
| 1083104145 | Suite Living Senior Care of Roseville | Assisted Living Facility | 197 County Road B2 W, Roseville, MN 55113 | 2018-05-15 |
| 1477055796 | Sunrise Residential Services LLC | Home Health | 216 Maple Ln, Roseville, MN 55113 | 2018-03-02 |
| 1194223024 | Alissa Hoff | Specialist | 1595 Mn 36 - 584 10 Rosedale Center, Roseville, MN 55113 | 2018-01-25 |
| 1841705118 | Kingsland Care Services Incorporated | Case Management | 2301 Rice Street, Suite 101, Roseville, MN 55113 | 2017-12-08 |
| Find all providers in zip 55113 | ||||
| Taxonomy Code | 291U00000X |
| Grouping | Laboratories |
| Classification | Clinical Medical Laboratory |
| (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology. |
| Notes: Source: (1) Code of Federal Regulations #42, Public Health, Section 493.2. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 186. |
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| 1225077225 | Sutter Health Sacramento Sierra Region | Clinical Medical Laboratory | 1 Medical Plaza Dr, Roseville, CA 95661-3037 | 2006-06-05 |
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| 1255995890 | Bunka Enterprise L.L.C. | Clinical Medical Laboratory | 701 Decatur Ave N Ste 101, Golden Valley, MN 55427-4363 | 2019-04-29 |
| 1578030839 | Laboratory Corporation of America Holdings | Clinical Medical Laboratory | 380 W County Road D, Saint Paul, MN 55112-3501 | 2018-10-25 |
| 1851805915 | Quest Diagnostics LLC Il | Clinical Medical Laboratory | 11091 Ulysses St Ne Ste 100, Blaine, MN 55434-4238 | 2017-11-28 |
| 1588178602 | Quest Diagnostics LLC Il | Clinical Medical Laboratory | 8515 Eagle Point Blvd Ste 100, Lake Elmo, MN 55042-8624 | 2017-11-28 |
| 1194241166 | Five Stars Recovery Center | Clinical Medical Laboratory | 1045 Stoughton Ave., Chaska, MN 55318 | 2017-08-21 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.