24D0405356 CLIA NUMBER - SOUTH SHORE CARE CENTER

Laboratory Demographics

  • CLIA Code: 24D0405356
  • Facility Name: SOUTH SHORE CARE CENTER
  • Facility Address: 1307 SOUTH SHORE DRIVE
    WORTHINGTON, MN
    ZIP 56187
  • Facility Phone: 507 376-3175
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: STACEY LUONG
  • NPI Number: 1225068588
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 24D0405356
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name SOUTH SHORE CARE CENTER
Street 1307 SOUTH SHORE DRIVE
City WORTHINGTON
State MN
ZIP 56187
Phone 507 376-3175
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 STACEY LUONG

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