24D1069576 CLIA NUMBER - FAIRVIEW WOODS DBA DEER CREST

Laboratory Demographics

CLIA Number: 24D1069576

Facility Name: FAIRVIEW WOODS DBA DEER CREST

Facility Address:
470 HEWITT BLVD
RED WING, MN
ZIP 55066
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Facility Phone Number: 651 267-5444

Facility Type: Home Health Agency

Certificate Type: Waiver

NPI Number: 1053589358

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	24D1069576
LAB Type	Home Health Agency
Facility Name	FAIRVIEW WOODS DBA DEER CREST
Street	470 HEWITT BLVD
City	RED WING
State	MN
ZIP	55066
Phone	651 267-5444
CertificateType	4
CertificateEffectiveDate	6/8/2023
CertificateExpirationDate	6/7/2025
FacilityType	Waiver

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