CLIA lab
CLIA 24D0664275: Good Samaritan Village
Mountain Lake, MN. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 24D0664275 belongs to Good Samaritan Village in Mountain Lake, MN.
Certificate of Waiver, effective September 1, 2026, expires August 31, 2028.
Active in the CMS Provider of Services file posted October 16, 2026.
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
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Certificate
- Certificate type
- Certificate of Waiver
- Certificate effective
- September 1, 2026
- Certificate expiration
- August 31, 2028
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- December 24, 1992
- Facility type
- Skilled nursing or nursing facility
- Ownership (control type)
- Private
- Lab classification
- CLIA laboratory
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 24D0664275
- Lab name
- Good Samaritan Village
- Address
- 745 Basinger Memorial Drive, Mountain Lake, MN 56159
- Phone
- (507) 427-2464
- Fax
- (507) 427-3036
Annual test volume the lab reported
- Waived tests
- 147,800
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Care facility at this address
- Good Samaritan Society - Mountain LakeCMS Care Compare ratings for the facility at the same street address
Other labs in Mountain Lake, MN
- Mountain Lake Pharmacy LLCCertificate of Waiver, Pharmacy24D2189091
- Sanford Health - Mountain Lake ClinicCertificate of Waiver, Rural health clinic24D0405271
- Sanford Laboratories - Mountain LakeCertificate of Accreditation, Independent24D1061124
- The Lodge of Mountain LakeCertificate of Waiver, Assisted living facility24D1016198
Related
Questions
What is the CLIA number for Good Samaritan Village in Mountain Lake?
24D0664275, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Good Samaritan Village hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 24D0664275 expire?
The CMS file lists August 31, 2028 as the certificate expiration date; the certificate took effect September 1, 2026.