43D2247471 CLIA NUMBER - THE VICTORIAN ASSISTED LIVING

Laboratory Demographics

CLIA Number: 43D2247471

Facility Name: THE VICTORIAN ASSISTED LIVING

Facility Address:
1321 COLUMBUS ST
RAPID CITY, SD
ZIP 57701
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Facility Phone Number: 605 342-1913

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1629277223

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	43D2247471
LAB Type	Assisted Living Facility
Facility Name	THE VICTORIAN ASSISTED LIVING
Street	1321 COLUMBUS ST
City	RAPID CITY
State	SD
ZIP	57701
Phone	605 342-1913
CertificateType	4
CertificateEffectiveDate	1/6/2024
CertificateExpirationDate	1/5/2026
FacilityType	Waiver

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