24D2005020 CLIA NUMBER - STILLE HAVN HUS

Laboratory Demographics

CLIA Code: 24D2005020
Facility Name: STILLE HAVN HUS
Facility Address: 170 WALKER INDUSTRIES BLVD
WALKER, MN
ZIP 56484
Facility Phone: 218 547-5920
Facility Type: Other - FOSTER CARE FACILITY
Facility Type: Waiver
Lab Director: ALEX ROGEN
NPI Number: 1528253978
Taxonomy: 320800000X - Community Based Residential Treatment Facility, Mental Illness

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CLIA Record

Field Name	Field Value
CLIA Number	24D2005020
LAB Type	Other - FOSTER CARE FACILITY
Facility Name	STILLE HAVN HUS
Street	170 WALKER INDUSTRIES BLVD
City	WALKER
State	MN
ZIP	56484
Phone	218 547-5920
Certificate Type	Certificate of Waiver
Certificate Type Description	This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date	3/18/2024
Certificate Expiration Date	3/17/2026
Facility Type	Other - FOSTER CARE FACILITY
Lab Director	ALEX ROGEN

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