24D2122430 CLIA NUMBER - REM SOUTHWEST SERVICE MONTEVIDEO ICF

Laboratory Demographics

  • CLIA Code: 24D2122430
  • Facility Name: REM SOUTHWEST SERVICE MONTEVIDEO ICF
  • Facility Address: 585 GRAVEL ROAD
    MONTEVIDEO, MN
    ZIP 56265
  • Facility Phone: (507) 223-5633
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: RITA M. PORTTIIN
  • NPI Number: 1538341649
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 24D2122430
LAB Type Assisted Living Facility
Facility Name REM SOUTHWEST SERVICE MONTEVIDEO ICF
Street 585 GRAVEL ROAD
City MONTEVIDEO
State MN
ZIP 56265
Phone 5072235633
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/21/2025
Certificate Expiration Date 12/20/2027
Facility Type Assisted Living Facility
Lab Director RITA M. PORTTIIN

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