24D1075998 CLIA NUMBER - COUNTRYSIDE CATERED SENIOR LIVING

Laboratory Demographics

  • CLIA Code: 24D1075998
  • Facility Name: COUNTRYSIDE CATERED SENIOR LIVING
  • Facility Address: 650 EL DORADO STREET
    OWATONNA, MN
    ZIP 55060
  • Facility Phone: 507 446-8334
  • Facility Type: Other
  • Facility Type: Waiver
  • Lab Director: TAMI HALEY
  • NPI Number: 1124234554
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 24D1075998
LAB Type Other
Facility Name COUNTRYSIDE CATERED SENIOR LIVING
Street 650 EL DORADO STREET
City OWATONNA
State MN
ZIP 55060
Phone 507 446-8334
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/2/2023
Certificate Expiration Date 11/1/2025
Facility Type Other
Lab Director TAMI HALEY

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