24D2139563 CLIA NUMBER - CANNON COUNTRY

Laboratory Demographics

  • CLIA Code: 24D2139563
  • Facility Name: CANNON COUNTRY
  • Facility Address: 308 LARKSPUR LANE
    CANNON FALLS, MN
    ZIP 55009
  • Facility Phone: 507 320-3788
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: ASHLYN B. HALLMAN
  • NPI Number: 1144861139
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 24D2139563
LAB Type Assisted Living Facility
Facility Name CANNON COUNTRY
Street 308 LARKSPUR LANE
City CANNON FALLS
State MN
ZIP 55009
Phone 507 320-3788
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/6/2023
Certificate Expiration Date 11/5/2025
Facility Type Assisted Living Facility
Lab Director ASHLYN B. HALLMAN

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