24D2090963 CLIA NUMBER - LEGACY PLACE LLC

Laboratory Demographics

  • CLIA Code: 24D2090963
  • Facility Name: LEGACY PLACE LLC
  • Facility Address: 902 15TH AVE NE
    SAUK RAPIDS, MN
    ZIP 56379
  • Facility Phone: (320) 259-7988
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: SUSAN GARDING
  • NPI Number: 1255720074
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 24D2090963
LAB Type Assisted Living Facility
Facility Name LEGACY PLACE LLC
Street 902 15TH AVE NE
City SAUK RAPIDS
State MN
ZIP 56379
Phone 3202597988
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/3/2025
Certificate Expiration Date 2/2/2027
Facility Type Assisted Living Facility
Lab Director SUSAN GARDING

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This page was last updated on: 5/18/2026