52D0674269 CLIA NUMBER - AMERICAN LUTHERAN HOMES INC

Laboratory Demographics

  • CLIA Code: 52D0674269
  • Facility Name: AMERICAN LUTHERAN HOMES INC
  • Facility Address: 200 MEMORIAL DRIVE
    MONDOVI, WI
    ZIP 54755
  • Facility Phone: 715 926-7962
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: MS. JENNY LILYQUIST
  • NPI Number: 1215978697
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 52D0674269
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name AMERICAN LUTHERAN HOMES INC
Street 200 MEMORIAL DRIVE
City MONDOVI
State WI
ZIP 54755
Phone 715 926-7962
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director MS. JENNY LILYQUIST

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