24D0969071 CLIA NUMBER - BROOKRIDGE

Laboratory Demographics

  • CLIA Code: 24D0969071
  • Facility Name: BROOKRIDGE
  • Facility Address: 180 SUNSET AVENUE
    COKATO, MN
    ZIP 55321
  • Facility Phone: 320 286-3190
  • Facility Type: Other
  • Facility Type: Waiver
  • Lab Director: JESSICA K. FUDALI
  • NPI Number: 1104040211
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 24D0969071
LAB Type Other
Facility Name BROOKRIDGE
Street 180 SUNSET AVENUE
City COKATO
State MN
ZIP 55321
Phone 320 286-3190
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/4/2024
Certificate Expiration Date 1/3/2026
Facility Type Other
Lab Director JESSICA K. FUDALI

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