24D1090454 CLIA NUMBER - MALA STRANA ASSISTED LIVING

Laboratory Demographics

  • CLIA Code: 24D1090454
  • Facility Name: MALA STRANA ASSISTED LIVING
  • Facility Address: 999 COLUMBUS AVE NORTH
    NEW PRAGUE, MN
    ZIP 56071
  • Facility Phone: 952 758-2511
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: MELISSA SHERMAN
  • NPI Number: 1295079945
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 24D1090454
LAB Type Assisted Living Facility
Facility Name MALA STRANA ASSISTED LIVING
Street 999 COLUMBUS AVE NORTH
City NEW PRAGUE
State MN
ZIP 56071
Phone 952 758-2511
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/10/2024
Certificate Expiration Date 10/9/2026
Facility Type Assisted Living Facility
Lab Director MELISSA SHERMAN

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