24D1053625 CLIA NUMBER - MILL STREET RESIDENCE

Laboratory Demographics

  • CLIA Code: 24D1053625
  • Facility Name: MILL STREET RESIDENCE
  • Facility Address: 802 SO MILL STREET
    FERGUS FALLS, MN
    ZIP 56537
  • Facility Phone: 218 739-2900
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: MICHAEL D. SIEMS
  • NPI Number: 1679783997
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 24D1053625
LAB Type Home Health Agency
Facility Name MILL STREET RESIDENCE
Street 802 SO MILL STREET
City FERGUS FALLS
State MN
ZIP 56537
Phone 218 739-2900
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/30/2024
Certificate Expiration Date 4/29/2026
Facility Type Home Health Agency
Lab Director MICHAEL D. SIEMS

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