24D2231265 CLIA NUMBER - CHESTNUT GROVE

Laboratory Demographics

  • CLIA Code: 24D2231265
  • Facility Name: CHESTNUT GROVE
  • Facility Address: 1204 CHESTNUT STREET W
    VIRGINIA, MN
    ZIP 55792
  • Facility Phone: 218 749-6847
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: JOANNA M. FRISBY
  • NPI Number: 1770718926
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 24D2231265
LAB Type Assisted Living Facility
Facility Name CHESTNUT GROVE
Street 1204 CHESTNUT STREET W
City VIRGINIA
State MN
ZIP 55792
Phone 218 749-6847
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/2/2025
Certificate Expiration Date 8/1/2027
Facility Type Assisted Living Facility
Lab Director JOANNA M. FRISBY

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