24D0403924 CLIA NUMBER - BAYSHORE RESIDENCE AND REHABILITATION CENTER

Laboratory Demographics

  • CLIA Code: 24D0403924
  • Facility Name: BAYSHORE RESIDENCE AND REHABILITATION CENTER
  • Facility Address: 1601 ST LOUIS AVE
    DULUTH, MN
    ZIP 55802
  • Facility Phone: 218 727-8651
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: DR. DAVID S. SPROAT
  • NPI Number: 1821433426
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 24D0403924
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name BAYSHORE RESIDENCE AND REHABILITATION CENTER
Street 1601 ST LOUIS AVE
City DULUTH
State MN
ZIP 55802
Phone 218 727-8651
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 DR. DAVID S. SPROAT

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