43D2199802 CLIA NUMBER - LEISURE LIVING- SALEM

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Laboratory Demographics

CLIA Number: 43D2199802

Facility Name: LEISURE LIVING- SALEM

Facility Address:
600 SOUTH HILL ST
SALEM, SD
ZIP 57058
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Facility Phone Number: 605 425-2858

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1730347097

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	43D2199802
LAB Type	Assisted Living Facility
Facility Name	LEISURE LIVING- SALEM
Street	600 SOUTH HILL ST
City	SALEM
State	SD
ZIP	57058
Phone	605 425-2858
CertificateType	4
CertificateEffectiveDate	11/10/2022
CertificateExpirationDate	11/9/2024
FacilityType	Waiver

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