Organization
MINNESOTA EYE LASER & SURGERY CENTERS, LLC
Active
Other names
Minnesota Eye Laser & Surgery Centers
Organization subpart
No
Provider details
NPI number
Authorized official
CLIFTON BAZHAW (SR VP REVENUE CYCLE)
(214) 893-0471
Entity
Organization
Contact information
Practice address
11091 ULYSSES STREET NE, SUITE 400, BLAINE, MN 55434-4237
(952) 888-5800
(952) 567-6156
Mailing address
9801 DUPONT AVE S, SUITE 425, BLOOMINGTON, MN 55431-3100
(952) 888-5800
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
24D2007008
CLIA
MN
Enumeration date
04/09/2010
Last updated
03/02/2026
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