24D2124620 CLIA NUMBER - PRAIRIE PINES COMMUNITY

Laboratory Demographics

  • CLIA Code: 24D2124620
  • Facility Name: PRAIRIE PINES COMMUNITY
  • Facility Address: 903 PRAIRIE PINES DRIVE
    FOSSTON, MN
    ZIP 56542
  • Facility Phone: 218 435-1337
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: AARON W. SYKES
  • NPI Number: 1407268642
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 24D2124620
LAB Type Assisted Living Facility
Facility Name PRAIRIE PINES COMMUNITY
Street 903 PRAIRIE PINES DRIVE
City FOSSTON
State MN
ZIP 56542
Phone 218 435-1337
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/23/2025
Certificate Expiration Date 1/22/2027
Facility Type Assisted Living Facility
Lab Director AARON W. SYKES

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