24D2276532 CLIA NUMBER - SUITE LIVING OF SHAKOPEE

Laboratory Demographics

CLIA Number: 24D2276532

Facility Name: SUITE LIVING OF SHAKOPEE

Facility Address:
1645 WINDERMERE WAY
SHAKOPEE, MN
ZIP 55379
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Facility Phone Number: 952 693-0030

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1558027268

Taxonomy: 310400000X - Assisted Living Facility
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

CLIA Record

Field Name	Field Value
CLIA Number	24D2276532
LAB Type	Assisted Living Facility
Facility Name	SUITE LIVING OF SHAKOPEE
Street	1645 WINDERMERE WAY
City	SHAKOPEE
State	MN
ZIP	55379
Phone	952 693-0030
CertificateType	4
CertificateEffectiveDate	2/10/2023
CertificateExpirationDate	2/9/2025
FacilityType	Waiver

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