35D2067476 CLIA NUMBER - EDGEWOOD MANDAN SENIOR LIVING, LLC

Laboratory Demographics

  • CLIA Code: 35D2067476
  • Facility Name: EDGEWOOD MANDAN SENIOR LIVING, LLC
  • Facility Address: 2801 39TH AVE SE
    MANDAN, ND
    ZIP 58554
  • Facility Phone: 701 391-5777
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: JAIDEN BENNETT
  • NPI Number: 1306243647
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 35D2067476
LAB Type Assisted Living Facility
Facility Name EDGEWOOD MANDAN SENIOR LIVING, LLC
Street 2801 39TH AVE SE
City MANDAN
State ND
ZIP 58554
Phone 701 391-5777
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/16/2025
Certificate Expiration Date 10/15/2027
Facility Type Assisted Living Facility
Lab Director JAIDEN BENNETT

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