24D1062276 CLIA NUMBER - EDGEWOOD MAY CREEK LLC

Laboratory Demographics

  • CLIA Code: 24D1062276
  • Facility Name: EDGEWOOD MAY CREEK LLC
  • Facility Address: 303 10TH STREET SOUTH
    WALKER, MN
    ZIP 56484
  • Facility Phone: 218 547-4515
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: DENISE H. NOVAK
  • NPI Number: 1053794362
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 24D1062276
LAB Type Assisted Living Facility
Facility Name EDGEWOOD MAY CREEK LLC
Street 303 10TH STREET SOUTH
City WALKER
State MN
ZIP 56484
Phone 218 547-4515
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/11/2024
Certificate Expiration Date 12/10/2026
Facility Type Assisted Living Facility
Lab Director DENISE H. NOVAK

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