24D2109842 CLIA NUMBER - EDGEWOOD SARTELL

Laboratory Demographics

CLIA Number: 24D2109842

Facility Name: EDGEWOOD SARTELL

Facility Address:
677 BRIANNA DRIVE
SARTELL, MN
ZIP 56377
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Facility Phone Number: 320 281-3343

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1093253346

Taxonomy: 310400000X - Assisted Living Facility
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

CLIA Record

Field Name	Field Value
CLIA Number	24D2109842
LAB Type	Assisted Living Facility
Facility Name	EDGEWOOD SARTELL
Street	677 BRIANNA DRIVE
City	SARTELL
State	MN
ZIP	56377
Phone	320 281-3343
CertificateType	4
CertificateEffectiveDate	3/3/2024
CertificateExpirationDate	3/2/2026
FacilityType	Waiver

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