24D0406036 CLIA NUMBER - COUNTRY MANOR CAMPUS LLC COUNTRY MANOR HEALTH CARE AND REHAB CENTER

Laboratory Demographics

  • CLIA Code: 24D0406036
  • Facility Name: COUNTRY MANOR CAMPUS LLC COUNTRY MANOR HEALTH CARE AND REHAB CENTER
  • Facility Address: 520 - 1ST ST NE
    SARTELL, MN
    ZIP 56377
  • Facility Phone: 320 253-1920
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: BECKY FRERICKS
  • NPI Number: 1952575011
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 24D0406036
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name COUNTRY MANOR CAMPUS LLC COUNTRY MANOR HEALTH CARE AND REHAB CENTER
Street 520 - 1ST ST NE
City SARTELL
State MN
ZIP 56377
Phone 320 253-1920
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/18/2024
Certificate Expiration Date 9/17/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director BECKY FRERICKS

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