24D0651607 CLIA NUMBER - ST CLOUD SURGICAL CENTER

Laboratory Demographics

CLIA Number: 24D0651607

Facility Name: ST CLOUD SURGICAL CENTER

Facility Address:
1526 NORTHWAY DRIVE
SAINT CLOUD, MN
ZIP 56303
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Facility Phone Number: 320 251-8385

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1124084843

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	24D0651607
LAB Type	Ambulatory Surgery Center
Facility Name	ST CLOUD SURGICAL CENTER
Street	1526 NORTHWAY DRIVE
City	SAINT CLOUD
State	MN
ZIP	56303
Phone	320 251-8385
CertificateType	4
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	Waiver

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