24D0671185 CLIA NUMBER - HAVENWOOD CARE CENTER

Laboratory Demographics

  • CLIA Code: 24D0671185
  • Facility Name: HAVENWOOD CARE CENTER
  • Facility Address: 1633 DELTON AVENUE
    BEMIDJI, MN
    ZIP 56601
  • Facility Phone: 218 444-1745
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: ROBERT JOHANNSEN
  • NPI Number: 1295836237
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 24D0671185
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name HAVENWOOD CARE CENTER
Street 1633 DELTON AVENUE
City BEMIDJI
State MN
ZIP 56601
Phone 218 444-1745
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 ROBERT JOHANNSEN

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