24D0404091 CLIA NUMBER - ESSENTIA HEALTH PROCTOR CLINIC

Laboratory Demographics

  • CLIA Code: 24D0404091
  • Facility Name: ESSENTIA HEALTH PROCTOR CLINIC
  • Facility Address: 211 S BOUNDARY AVE
    PROCTOR, MN
    ZIP 55810
  • Facility Phone: 218 576-0448
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SANDRA MATTSON
  • NPI Number: 1902103831
  • Taxonomy: 261QM1300X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 24D0404091
LAB Type Physician Office
Facility Name ESSENTIA HEALTH PROCTOR CLINIC
Street 211 S BOUNDARY AVE
City PROCTOR
State MN
ZIP 55810
Phone 218 576-0448
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/1/2025
Certificate Expiration Date 9/30/2027
Facility Type Physician Office
Lab Director SANDRA MATTSON

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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