CRYSTAL EDGE LLC
NPI 1093434151
Assisted Living Facility in Brooklyn Park, MN
About Crystal Edge Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
CRYSTAL EDGE LLC (NPI 1093434151) is a healthcare organization registered as an assisted living facility in Brooklyn Park, Minnesota and active in the NPI registry since August 2022. The organization holds 2 active CLIA laboratory certificates and lists Haja Dean, Designated Coordinator, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
CLIA Laboratory Certificates CMS CLIA 2
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 24D2321199
Crystal Edge LLC · Brooklyn Park, MNCertificate of Waiver 24D2327274
Crystal Edge 2 LLC · Saint Paul, MNOther Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Crystal Edge LLC's NPI number?
The NPI number for Crystal Edge LLC is 1093434151. It was assigned to this organization in the NPPES registry on August 23, 2022.
Where is Crystal Edge LLC located?
Crystal Edge LLC is located at 9119 Regent Pkwy, Brooklyn Park, MN 55443. The listed phone number is (612) 459-2724.
What is Crystal Edge LLC's specialty?
The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.
Does Crystal Edge LLC hold CLIA laboratory certificates?
Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.
When was this NPI record last updated?
The NPPES record for Crystal Edge LLC was last updated on September 29, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Crystal Edge Llc · NPI 1093434151
Assisted Living Facility organization in Brooklyn Park, Minnesota. Organization record, active in the CMS NPPES registry since August 23, 2022.
## Identity
- **NPI:** 1093434151 (Entity type: Organization)
- **Enumerated:** August 23, 2022
- **Primary specialty:** Assisted Living Facility · taxonomy 310400000X
- **Organization subpart:** No
- **Authorized official:** Haja Dean, DESIGNATED COORDINATOR
## Practice location
- **Address:** 9119 REGENT PKWY, Brooklyn Park, MN 55443-1660
- **Phone:** (612) 459-2724
## Record status
- **NPPES last updated:** September 29, 2023
- **CLIA laboratory certificates:** 2 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1093434151) · Data from the CMS NPPES public registry.