24D0701604 CLIA NUMBER - VILLA ST VINCENT

Laboratory Demographics

  • CLIA Code: 24D0701604
  • Facility Name: VILLA ST VINCENT
  • Facility Address: 516 WALSH ST
    CROOKSTON, MN
    ZIP 56716
  • Facility Phone: 218 281-3424
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: LAVONNE MERTEN
  • NPI Number: 1215932728
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 24D0701604
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name VILLA ST VINCENT
Street 516 WALSH ST
City CROOKSTON
State MN
ZIP 56716
Phone 218 281-3424
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 LAVONNE MERTEN

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