24D0663272 CLIA NUMBER - EMMANUEL NURSING HOME

Laboratory Demographics

  • CLIA Code: 24D0663272
  • Facility Name: EMMANUEL NURSING HOME
  • Facility Address: 1415 MADISON AVE
    DETROIT LAKES, MN
    ZIP 56501
  • Facility Phone: 218 847-4486
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: BRIDGET OKERSON
  • NPI Number: 1780926444
  • Taxonomy: 251E00000X - Home Health

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 24D0663272
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name EMMANUEL NURSING HOME
Street 1415 MADISON AVE
City DETROIT LAKES
State MN
ZIP 56501
Phone 218 847-4486
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 BRIDGET OKERSON

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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