24D2070886 CLIA NUMBER - TRIPLE ANGELS HEALTHCARE

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Laboratory Demographics

CLIA Number: 24D2070886

Facility Name: TRIPLE ANGELS HEALTHCARE

Facility Address:
7150 WEST POINT DOUGLAS RD S
COTTAGE GROVE, MN
ZIP 55016
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Facility Phone Number: 651 795-8290

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1871711507

Taxonomy: 320700000X - Residential Treatment Facility, Physical Disabilities
A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with physical disabilities and are not able to live independently.

CLIA Record

Field Name	Field Value
CLIA Number	24D2070886
LAB Type	Assisted Living Facility
Facility Name	TRIPLE ANGELS HEALTHCARE
Street	7150 WEST POINT DOUGLAS RD S
City	COTTAGE GROVE
State	MN
ZIP	55016
Phone	651 795-8290
CertificateType	4
CertificateEffectiveDate	12/27/2023
CertificateExpirationDate	12/26/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024