24D0726320 CLIA NUMBER - PRAIRIE MANOR INC

Laboratory Demographics

  • CLIA Code: 24D0726320
  • Facility Name: PRAIRIE MANOR INC
  • Facility Address: 220 3RD ST NW
    BLOOMING PRAIRIE, MN
    ZIP 55917
  • Facility Phone: (507) 583-4434
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: BRANDON P. VERDOORN
  • NPI Number: 1356343701
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 24D0726320
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name PRAIRIE MANOR INC
Street 220 3RD ST NW
City BLOOMING PRAIRIE
State MN
ZIP 55917
Phone 5075834434
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 BRANDON P. VERDOORN

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This page was last updated on: 5/18/2026