24D0406058 CLIA NUMBER - GOOD SHEPHERD LUTHERAN HOME

Laboratory Demographics

  • CLIA Code: 24D0406058
  • Facility Name: GOOD SHEPHERD LUTHERAN HOME
  • Facility Address: 1115 N 4TH AVE
    SAUK RAPIDS, MN
    ZIP 56379
  • Facility Phone: 320 252-6525
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: JACKIE BARBER
  • NPI Number: 1336316611
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 24D0406058
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name GOOD SHEPHERD LUTHERAN HOME
Street 1115 N 4TH AVE
City SAUK RAPIDS
State MN
ZIP 56379
Phone 320 252-6525
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 JACKIE BARBER

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