24D1068783 CLIA NUMBER - HAMMER RESIDENCES, INC

Laboratory Demographics

CLIA Number: 24D1068783

Facility Name: HAMMER RESIDENCES, INC

Facility Address:
1909 WAYZATA BLVD E
WAYZATA, MN
ZIP 55391
Get Directions

Facility Phone Number: 952 277-2454

Facility Type: Intermediate Care Facility for Mentally Retarded

Certificate Type: Waiver

NPI Number: 1598808446

Taxonomy: 320900000X - Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities.

CLIA Record

Field Name	Field Value
CLIA Number	24D1068783
LAB Type	Intermediate Care Facility for Mentally Retarded
Facility Name	HAMMER RESIDENCES, INC
Street	1909 WAYZATA BLVD E
City	WAYZATA
State	MN
ZIP	55391
Phone	952 277-2454
CertificateType	4
CertificateEffectiveDate	5/21/2023
CertificateExpirationDate	5/20/2025
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

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