24D1057526 CLIA NUMBER - HOLLY RIDGE MANOR

Laboratory Demographics

  • CLIA Code: 24D1057526
  • Facility Name: HOLLY RIDGE MANOR
  • Facility Address: 500 HOLLY RIDGE DRIVE
    STARBUCK, MN
    ZIP 56381
  • Facility Phone: 320 239-4775
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: DANIELLE LYNGEN
  • NPI Number: 1811091036
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 24D1057526
LAB Type Assisted Living Facility
Facility Name HOLLY RIDGE MANOR
Street 500 HOLLY RIDGE DRIVE
City STARBUCK
State MN
ZIP 56381
Phone 320 239-4775
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/15/2024
Certificate Expiration Date 8/14/2026
Facility Type Assisted Living Facility
Lab Director DANIELLE LYNGEN

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