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LINO LAKES GW, LLC
NPI 1720462617
Assisted Living Facility in Lino Lakes, MN

Active since July 10, 2015CLIA 24D2100453 · Waiver
675 MARKET PLACE DRIVE, LINO LAKES, MN 55014(651) 287-0265 Get Directions Write a Review

NPPES record last updated: July 10, 2015. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Lino Lakes Gw, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LINO LAKES GW, LLC (NPI 1720462617) is a healthcare organization registered as an assisted living facility in Lino Lakes, Minnesota and active in the NPI registry since July 2015. The organization holds a CLIA Waiver certificate valid through August 13, 2027 and lists Sarah Pauley, Business Manager, as its authorized official.

NPPES Registry Identity

NPI1720462617
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameLINO LAKES GW, LLC
Location Address675 MARKET PLACE DRIVELino Lakes, MN 55014
Mailing Address750 Main StMendota Heights, MN 55118-3764
Phone(651) 287-0265
Organization SubpartNo
Authorized OfficialSarah PauleyBusiness Manager · (651) 287-0265
Enumeration DateJuly 10, 2015
✔ NPI 1720462617 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
License✔ Licensed in MN · 372756
Definition
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.
675 MARKET PLACE DRIVE, Lino Lakes, MN 55014
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CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 24D2100453

Lino Lakes Gracewood · Lino Lakes, MN
Active · expires Aug 13, 2027
CLIA Number24D2100453
Laboratory TypeAssisted Living Facility
Certificate Effective DateAugust 14, 2025
Certificate Expiration DateAugust 13, 2027
Laboratory DirectorBrittany Rands
Laboratory Phone(651) 202-3456
Laboratory LocationLino Lakes Gracewood675 Market Place Drive, Lino Lakes, MN 55014
CLIA data matches this NPI record on: Address
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lino Lakes Gw, LLC's NPI number?

The NPI number for Lino Lakes Gw, LLC is 1720462617. It was assigned to this organization in the NPPES registry on July 10, 2015.

Where is Lino Lakes Gw, LLC located?

Lino Lakes Gw, LLC is located at 675 Market Place Drive, Lino Lakes, MN 55014. The listed phone number is (651) 287-0265.

What is Lino Lakes Gw, LLC's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Does Lino Lakes Gw, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 24D2100453) is associated with this NPI, valid through August 13, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Lino Lakes Gw, LLC was last updated on July 10, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.