43D1036492 CLIA NUMBER - HERITAGE SENIOR LIVING

Laboratory Demographics

CLIA Number: 43D1036492

Facility Name: HERITAGE SENIOR LIVING

Facility Address:
211 NW 1ST STREET
MADISON, SD
ZIP 57042
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Facility Phone Number: 605 256-1525

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1679794002

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	43D1036492
LAB Type	Assisted Living Facility
Facility Name	HERITAGE SENIOR LIVING
Street	211 NW 1ST STREET
City	MADISON
State	SD
ZIP	57042
Phone	605 256-1525
CertificateType	4
CertificateEffectiveDate	2/4/2023
CertificateExpirationDate	2/3/2025
FacilityType	Waiver

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