24D0403928 CLIA NUMBER - SENIOR FRIEND HOME CARE

Laboratory Demographics

  • CLIA Code: 24D0403928
  • Facility Name: SENIOR FRIEND HOME CARE
  • Facility Address: 1111 CLOQUET AVENUE, STE 3,
    CLOQUET, MN
    ZIP 55720
  • Facility Phone: 218 727-1111
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: KELLY R. RUBOTTOM
  • NPI Number: 1619350436
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 24D0403928
LAB Type Home Health Agency
Facility Name SENIOR FRIEND HOME CARE
Street 1111 CLOQUET AVENUE, STE 3,
City CLOQUET
State MN
ZIP 55720
Phone 218 727-1111
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 Home Health Agency
Lab Director KELLY R. RUBOTTOM

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