16D1071185 CLIA NUMBER - MILLS HARBOUR INDEPENDENT/ASSISTED LIVING

Laboratory Demographics

CLIA Number: 16D1071185

Facility Name: MILLS HARBOUR INDEPENDENT/ASSISTED LIVING

Facility Address:
311 SOUTH 10TH AVENUE EAST
LAKE MILLS, IA
ZIP 50450
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Facility Phone Number: 641 592-3050

Facility Type: Skilled Nursing Facility/Nursing Facility

Certificate Type: Waiver

NPI Number: 1629243324

Taxonomy: 310400000X - Assisted Living Facility
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

CLIA Record

Field Name	Field Value
CLIA Number	16D1071185
LAB Type	Skilled Nursing Facility/Nursing Facility
Facility Name	MILLS HARBOUR INDEPENDENT/ASSISTED LIVING
Street	311 SOUTH 10TH AVENUE EAST
City	LAKE MILLS
State	IA
ZIP	50450
Phone	641 592-3050
CertificateType	4
CertificateEffectiveDate	7/19/2023
CertificateExpirationDate	7/18/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024