52D1105753 CLIA NUMBER - SCANDINAVIAN COURT ASSISTED LIVING

Laboratory Demographics

CLIA Number: 52D1105753

Facility Name: SCANDINAVIAN COURT ASSISTED LIVING

Facility Address:
346 SCANDINAVIAN CT
DENMARK, WI
ZIP 54208
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Facility Phone Number: 920 863-5362

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1922482157

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	52D1105753
LAB Type	Assisted Living Facility
Facility Name	SCANDINAVIAN COURT ASSISTED LIVING
Street	346 SCANDINAVIAN CT
City	DENMARK
State	WI
ZIP	54208
Phone	920 863-5362
CertificateType	4
CertificateEffectiveDate	9/28/2023
CertificateExpirationDate	9/27/2025
FacilityType	Waiver

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