24D2155589 CLIA NUMBER - PRAHA VILLAGE

Laboratory Demographics

  • CLIA Code: 24D2155589
  • Facility Name: PRAHA VILLAGE
  • Facility Address: 1100 1ST STREET SE
    NEW PRAGUE, MN
    ZIP 56071
  • Facility Phone: 952 855-8855
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: ASHLEY WAGNER
  • NPI Number: 1992279533
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 24D2155589
LAB Type Assisted Living Facility
Facility Name PRAHA VILLAGE
Street 1100 1ST STREET SE
City NEW PRAGUE
State MN
ZIP 56071
Phone 952 855-8855
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/2/2024
Certificate Expiration Date 10/1/2026
Facility Type Assisted Living Facility
Lab Director ASHLEY WAGNER

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