24D2284412 CLIA NUMBER - SHEPHERD'S HOME LLC DBA MANGER'S WAY HOME

Laboratory Demographics

  • CLIA Code: 24D2284412
  • Facility Name: SHEPHERD'S HOME LLC DBA MANGER'S WAY HOME
  • Facility Address: 10652 ALISON WAY
    INVER GROVE HEIGHTS, MN
    ZIP 55077
  • Facility Phone: 612 308-1220
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: ELIBELLE JARDIO
  • NPI Number: 1760191001
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 24D2284412
LAB Type Assisted Living Facility
Facility Name SHEPHERD'S HOME LLC DBA MANGER'S WAY HOME
Street 10652 ALISON WAY
City INVER GROVE HEIGHTS
State MN
ZIP 55077
Phone 612 308-1220
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/22/2025
Certificate Expiration Date 6/21/2027
Facility Type Assisted Living Facility
Lab Director ELIBELLE JARDIO

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