24D0957658 CLIA NUMBER - NEW BEGINNINGS AT WAVERLY LLC

Laboratory Demographics

CLIA Number: 24D0957658

Facility Name: NEW BEGINNINGS AT WAVERLY LLC

Facility Address:
109 NORTH SHORE DR
WAVERLY, MN
ZIP 55390
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Facility Phone Number: 612 326-7561

Facility Type: Other - RULE 31 RESIDEN TREATMENT

Certificate Type: Waiver

NPI Number: 1386155901

Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility
A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.

CLIA Record

Field Name	Field Value
CLIA Number	24D0957658
LAB Type	Other - RULE 31 RESIDEN TREATMENT
Facility Name	NEW BEGINNINGS AT WAVERLY LLC
Street	109 NORTH SHORE DR
City	WAVERLY
State	MN
ZIP	55390
Phone	612 326-7561
CertificateType	4
CertificateEffectiveDate	2/25/2023
CertificateExpirationDate	2/24/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024