35D0408739 CLIA NUMBER - ROCK OF AGES

Laboratory Demographics

CLIA Number: 35D0408739

Facility Name: ROCK OF AGES

Facility Address:
1315 4TH STREET NE
JAMESTOWN, ND
ZIP 58401
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Facility Phone Number: 701 252-9292

Facility Type: Other

Certificate Type: Waiver

NPI Number: 1609945005

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	35D0408739
LAB Type	Other
Facility Name	ROCK OF AGES
Street	1315 4TH STREET NE
City	JAMESTOWN
State	ND
ZIP	58401
Phone	701 252-9292
CertificateType	4
CertificateEffectiveDate	7/29/2023
CertificateExpirationDate	7/28/2025
FacilityType	Waiver

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