16D0384303 CLIA NUMBER - LAKESIDE LUTHERAN HOME

Laboratory Demographics

  • CLIA Code: 16D0384303
  • Facility Name: LAKESIDE LUTHERAN HOME
  • Facility Address: 301 NORTH LAWLER STREET
    EMMETSBURG, IA
    ZIP 50536
  • Facility Phone: 712 852-4060
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: TARA JAGODZINSKE
  • NPI Number: 1902981061
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 16D0384303
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name LAKESIDE LUTHERAN HOME
Street 301 NORTH LAWLER STREET
City EMMETSBURG
State IA
ZIP 50536
Phone 712 852-4060
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director TARA JAGODZINSKE

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This page was last updated on: 9/29/2025