24D2240794 CLIA NUMBER - LEGACY COMMUNITY CARE INC

Laboratory Demographics

  • CLIA Code: 24D2240794
  • Facility Name: LEGACY COMMUNITY CARE INC
  • Facility Address: 1022 42 1/2 AVE NE
    COLUMBIA HEIGHTS, MN
    ZIP 55421
  • Facility Phone: 763 444-1893
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: AHMED YUSUF
  • NPI Number: 1699478040
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 24D2240794
LAB Type Assisted Living Facility
Facility Name LEGACY COMMUNITY CARE INC
Street 1022 42 1/2 AVE NE
City COLUMBIA HEIGHTS
State MN
ZIP 55421
Phone 763 444-1893
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/22/2023
Certificate Expiration Date 10/21/2025
Facility Type Assisted Living Facility
Lab Director AHMED YUSUF

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