24D1046877 CLIA NUMBER - GOLDEN NEST, LLC

Laboratory Demographics

CLIA Number: 24D1046877

Facility Name: GOLDEN NEST, LLC

Facility Address:
1918 19TH AVENUE NE
MINNEAPOLIS, MN
ZIP 55418
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Facility Phone Number: 651 755-2836

Facility Type: Home Health Agency

Certificate Type: Waiver

NPI Number: 1578648069

Taxonomy: 310400000X - Assisted Living Facility
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

CLIA Record

Field Name	Field Value
CLIA Number	24D1046877
LAB Type	Home Health Agency
Facility Name	GOLDEN NEST, LLC
Street	1918 19TH AVENUE NE
City	MINNEAPOLIS
State	MN
ZIP	55418
Phone	651 755-2836
CertificateType	4
CertificateEffectiveDate	7/14/2023
CertificateExpirationDate	7/13/2025
FacilityType	Waiver

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