24D2189155 CLIA NUMBER - ESSENTIA HEALTH-HOMESTEAD

Laboratory Demographics

CLIA Number: 24D2189155

Facility Name: ESSENTIA HEALTH-HOMESTEAD

Facility Address:
1053 COMSTOCK DRIVE
DEER RIVER, MN
ZIP 56636
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Facility Phone Number: 218 246-4510

Facility Type: Skilled Nursing Facility/Nursing Facility

Certificate Type: Waiver

NPI Number: 1306394101

Taxonomy: 261QR1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	24D2189155
LAB Type	Skilled Nursing Facility/Nursing Facility
Facility Name	ESSENTIA HEALTH-HOMESTEAD
Street	1053 COMSTOCK DRIVE
City	DEER RIVER
State	MN
ZIP	56636
Phone	218 246-4510
CertificateType	4
CertificateEffectiveDate	7/27/2022
CertificateExpirationDate	7/26/2024
FacilityType	Waiver

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