24D2294848 CLIA NUMBER - MINNESOTA VETERANS HOME MONTEVIDEO

Laboratory Demographics

  • CLIA Code: 24D2294848
  • Facility Name: MINNESOTA VETERANS HOME MONTEVIDEO
  • Facility Address: 2190 WILLIAM AVENUE
    MONTEVIDEO, MN
    ZIP 56265
  • Facility Phone: 320 435-4710
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: SEAN ERCAN-FANG
  • NPI Number: 1295966075
  • Taxonomy: 251300000X - Local Education Agency (LEA)

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CLIA Record

Field Name Field Value
CLIA Number 24D2294848
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name MINNESOTA VETERANS HOME MONTEVIDEO
Street 2190 WILLIAM AVENUE
City MONTEVIDEO
State MN
ZIP 56265
Phone 320 435-4710
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/30/2023
Certificate Expiration Date 11/29/2025
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director SEAN ERCAN-FANG

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