24D2152150 CLIA NUMBER - BRIDGEWAY ESTATES

Laboratory Demographics

CLIA Number: 24D2152150

Facility Name: BRIDGEWAY ESTATES

Facility Address:
103 12TH STREET NE
LITTLE FALLS, MN
ZIP 56345
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Facility Phone Number: 320 632-2062

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1043235716

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	24D2152150
LAB Type	Assisted Living Facility
Facility Name	BRIDGEWAY ESTATES
Street	103 12TH STREET NE
City	LITTLE FALLS
State	MN
ZIP	56345
Phone	320 632-2062
CertificateType	4
CertificateEffectiveDate	8/3/2022
CertificateExpirationDate	8/2/2024
FacilityType	Waiver

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