24D0651604 CLIA NUMBER - WABASSO RESTORATIVE CARE CENTER

Laboratory Demographics

  • CLIA Code: 24D0651604
  • Facility Name: WABASSO RESTORATIVE CARE CENTER
  • Facility Address: 660 MAPLE ST
    WABASSO, MN
    ZIP 56293
  • Facility Phone: 507 342-5166
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: VIKAS S. MITTAL
  • NPI Number: 1629513882
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 24D0651604
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name WABASSO RESTORATIVE CARE CENTER
Street 660 MAPLE ST
City WABASSO
State MN
ZIP 56293
Phone 507 342-5166
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/22/2025
Certificate Expiration Date 4/21/2027
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director VIKAS S. MITTAL

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