24D0403653 CLIA NUMBER - VILLA COURT LLC DBA VILLA VISTA AND CARDINAL COURT

Laboratory Demographics

  • CLIA Code: 24D0403653
  • Facility Name: VILLA COURT LLC DBA VILLA VISTA AND CARDINAL COURT
  • Facility Address: 1220 VILLA COURT DRIVE
    CROMWELL, MN
    ZIP 55726
  • Facility Phone: 218 644-3331
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: JULIE R. PETERSON
  • NPI Number: 1982889127
  • Taxonomy: 313M00000X - Nursing Facility/Intermediate Care Facility

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CLIA Record

Field Name Field Value
CLIA Number 24D0403653
LAB Type Assisted Living Facility
Facility Name VILLA COURT LLC DBA VILLA VISTA AND CARDINAL COURT
Street 1220 VILLA COURT DRIVE
City CROMWELL
State MN
ZIP 55726
Phone 218 644-3331
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 Assisted Living Facility
Lab Director JULIE R. PETERSON

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