# LIFESCAN MINNESOTA STAND UP MRI LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Parent organization:** LIFESCAN MINNESOTA STAND UP MRI LLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1134122054
- **Legal business name:** LIFESCAN MINNESOTA STAND UP MRI LLC
- **Authorized official:** MRS. MICHELLE DOUGLAS (CREDENTIALING MANAGER)
- **Authorized official phone:** (502) 403-1401

## Contact information

- **Practice address:** 5023 EXCELSIOR BLVD, STE 9B, ST LOUIS PARK, MN 55416-3013
- **Practice address phone:** (952) 920-8860
- **Practice address fax:** (952) 920-8869
- **Mailing address:** 5023 EXCELSIOR BLVD, STE 9B, ST LOUIS PARK, MN 55416-3013
- **Mailing address phone:** (952) 920-8860
- **Mailing address fax:** (952) 920-8869

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1200X | Magnetic Resonance Imaging (MRI) Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 05/24/2005
- **Last updated:** 07/07/2008