24D0398150 CLIA NUMBER - ALLINA HEALTH FARIBAULT CLINIC

Laboratory Demographics

  • CLIA Code: 24D0398150
  • Facility Name: ALLINA HEALTH FARIBAULT CLINIC
  • Facility Address: 100 STATE AVENUE
    FARIBAULT, MN
    ZIP 55021
  • Facility Phone: 507 334-3921
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: DR. LAWRENCE J. BURGART
  • NPI Number: 1336754555
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 24D0398150
LAB Type Community Clinic
Facility Name ALLINA HEALTH FARIBAULT CLINIC
Street 100 STATE AVENUE
City FARIBAULT
State MN
ZIP 55021
Phone 507 334-3921
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/25/2024
Certificate Expiration Date 1/24/2026
Facility Type Community Clinic
Lab Director DR. LAWRENCE J. BURGART

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