24D1070668 CLIA NUMBER - ECUMEN SAND PRAIRIE

Laboratory Demographics

CLIA Number: 24D1070668

Facility Name: ECUMEN SAND PRAIRIE

Facility Address:
700 KNIGHT STREET
ST PETER, MN
ZIP 56082
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Facility Phone Number: 507 931-4375

Facility Type: Other

Certificate Type: Waiver

NPI Number: 1821347477

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	24D1070668
LAB Type	Other
Facility Name	ECUMEN SAND PRAIRIE
Street	700 KNIGHT STREET
City	ST PETER
State	MN
ZIP	56082
Phone	507 931-4375
CertificateType	4
CertificateEffectiveDate	7/5/2023
CertificateExpirationDate	7/4/2025
FacilityType	Waiver

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