24D1046874 CLIA NUMBER - BROOKSIDE ASSISTED LIVING

Laboratory Demographics

  • CLIA Code: 24D1046874
  • Facility Name: BROOKSIDE ASSISTED LIVING
  • Facility Address: 2729 STATE 371 SW
    PINE RIVER, MN
    ZIP 56474
  • Facility Phone: 218 242-2498
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: NATALIE R. BURDICK
  • NPI Number: 1629338686
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 24D1046874
LAB Type Assisted Living Facility
Facility Name BROOKSIDE ASSISTED LIVING
Street 2729 STATE 371 SW
City PINE RIVER
State MN
ZIP 56474
Phone 218 242-2498
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/20/2023
Certificate Expiration Date 10/19/2025
Facility Type Assisted Living Facility
Lab Director NATALIE R. BURDICK

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