24D2042655 CLIA NUMBER - ASPEN GROVE ALT SENIOR LIVING

Laboratory Demographics

  • CLIA Code: 24D2042655
  • Facility Name: ASPEN GROVE ALT SENIOR LIVING
  • Facility Address: 511 IRON DR
    CHISHOLM, MN
    ZIP 55719
  • Facility Phone: 218 263-7330
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: BRENDA S. GARGANO
  • NPI Number: 1043777469
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 24D2042655
LAB Type Assisted Living Facility
Facility Name ASPEN GROVE ALT SENIOR LIVING
Street 511 IRON DR
City CHISHOLM
State MN
ZIP 55719
Phone 218 263-7330
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/18/2024
Certificate Expiration Date 6/17/2026
Facility Type Assisted Living Facility
Lab Director BRENDA S. GARGANO

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