24D2286965 CLIA NUMBER - GENESIS ASSISTED LIVING LLC

Laboratory Demographics

  • CLIA Code: 24D2286965
  • Facility Name: GENESIS ASSISTED LIVING LLC
  • Facility Address: 1019 SOUTH MADISON STREET
    SHAKOPEE, MN
    ZIP 55379
  • Facility Phone: 952 465-7877
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: JOAN J. MISOI
  • NPI Number: 1215635198
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 24D2286965
LAB Type Assisted Living Facility
Facility Name GENESIS ASSISTED LIVING LLC
Street 1019 SOUTH MADISON STREET
City SHAKOPEE
State MN
ZIP 55379
Phone 952 465-7877
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/7/2025
Certificate Expiration Date 8/6/2027
Facility Type Assisted Living Facility
Lab Director JOAN J. MISOI

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