24D1040148 CLIA NUMBER - WILLOW CREEK SENIOR COMMUNITY

Laboratory Demographics

  • CLIA Code: 24D1040148
  • Facility Name: WILLOW CREEK SENIOR COMMUNITY
  • Facility Address: 500 WILLOW CREEK DRIVE
    HENNING, MN
    ZIP 56551
  • Facility Phone: 218 338-1001
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: TIMOTHY R. KELLY
  • NPI Number: 1548227358
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 24D1040148
LAB Type Assisted Living Facility
Facility Name WILLOW CREEK SENIOR COMMUNITY
Street 500 WILLOW CREEK DRIVE
City HENNING
State MN
ZIP 56551
Phone 218 338-1001
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/2/2025
Certificate Expiration Date 5/1/2027
Facility Type Assisted Living Facility
Lab Director TIMOTHY R. KELLY

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