24D0403613 CLIA NUMBER - HERITAGE MANOR HEALTH CARE CENTER

Laboratory Demographics

  • CLIA Code: 24D0403613
  • Facility Name: HERITAGE MANOR HEALTH CARE CENTER
  • Facility Address: 321 NE 6TH ST
    CHISHOLM, MN
    ZIP 55719
  • Facility Phone: 218 254-5765
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: STACY J. BERNARD
  • NPI Number: 1508814575
  • Taxonomy: 314000000X - Skilled Nursing Facility

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 24D0403613
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name HERITAGE MANOR HEALTH CARE CENTER
Street 321 NE 6TH ST
City CHISHOLM
State MN
ZIP 55719
Phone 218 254-5765
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 STACY J. BERNARD

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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