43D0988587 CLIA NUMBER - EDGEWOOD GREENLEAF FLANDREAU LLC

Laboratory Demographics

CLIA Number: 43D0988587

Facility Name: EDGEWOOD GREENLEAF FLANDREAU LLC

Facility Address:
800 S WIND STREET
FLANDREAU, SD
ZIP 57028
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Facility Phone Number: 605 997-2775

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1720376114

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	43D0988587
LAB Type	Assisted Living Facility
Facility Name	EDGEWOOD GREENLEAF FLANDREAU LLC
Street	800 S WIND STREET
City	FLANDREAU
State	SD
ZIP	57028
Phone	605 997-2775
CertificateType	4
CertificateEffectiveDate	7/2/2023
CertificateExpirationDate	7/1/2025
FacilityType	Waiver

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