24D0406402 CLIA NUMBER - MAHNOMEN HEALTH CENTER

Laboratory Demographics

CLIA Number: 24D0406402

Facility Name: MAHNOMEN HEALTH CENTER

Facility Address:
414 W JEFFERSON AVE
MAHNOMEN, MN
ZIP 56557
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Facility Phone Number: 218 935-9417

Facility Type: Hospital

Certificate Type: Certificate of Compliance

NPI Number: 1114337268

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	24D0406402
LAB Type	Hospital
Facility Name	MAHNOMEN HEALTH CENTER
Street	414 W JEFFERSON AVE
City	MAHNOMEN
State	MN
ZIP	56557
Phone	218 935-9417
CertificateType	2
CertificateEffectiveDate	1/23/2024
CertificateExpirationDate	1/22/2026
FacilityType	Compliance

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