24D1031090 CLIA NUMBER - LONG LAKE ASSISTED LIVING

Laboratory Demographics

  • CLIA Code: 24D1031090
  • Facility Name: LONG LAKE ASSISTED LIVING
  • Facility Address: 345 N BROWN ROAD
    LONG LAKE, MN
    ZIP 55356
  • Facility Phone: 952 473-2527
  • Facility Type: Other
  • Facility Type: Waiver
  • Lab Director: BRIDGETTE L. KELLY
  • NPI Number: 1851470314
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 24D1031090
LAB Type Other
Facility Name LONG LAKE ASSISTED LIVING
Street 345 N BROWN ROAD
City LONG LAKE
State MN
ZIP 55356
Phone 952 473-2527
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/23/2024
Certificate Expiration Date 9/22/2026
Facility Type Other
Lab Director BRIDGETTE L. KELLY

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