24D2188673 CLIA NUMBER - LIGHTCARE GROUP HOMES LLC

Laboratory Demographics

  • CLIA Code: 24D2188673
  • Facility Name: LIGHTCARE GROUP HOMES LLC
  • Facility Address: 7539 16TH AVE S
    RICHFIELD, MN
    ZIP 55423
  • Facility Phone: 952 288-9420
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: MARYAM A. MOHAMED
  • NPI Number: 1447883475
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 24D2188673
LAB Type Assisted Living Facility
Facility Name LIGHTCARE GROUP HOMES LLC
Street 7539 16TH AVE S
City RICHFIELD
State MN
ZIP 55423
Phone 952 288-9420
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/21/2024
Certificate Expiration Date 7/20/2026
Facility Type Assisted Living Facility
Lab Director MARYAM A. MOHAMED

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