24D1102760 CLIA NUMBER - GRAND MEADOWS

Laboratory Demographics

  • CLIA Code: 24D1102760
  • Facility Name: GRAND MEADOWS
  • Facility Address: 1420 PRAIRIE AVENUE
    GLENCOE, MN
    ZIP 55336
  • Facility Phone: 320 864-5577
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: MIKAYLIN GOETZE
  • NPI Number: 1003047200
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 24D1102760
LAB Type Assisted Living Facility
Facility Name GRAND MEADOWS
Street 1420 PRAIRIE AVENUE
City GLENCOE
State MN
ZIP 55336
Phone 320 864-5577
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/23/2025
Certificate Expiration Date 7/22/2027
Facility Type Assisted Living Facility
Lab Director MIKAYLIN GOETZE

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