24D0651637 CLIA NUMBER - MILLE LACS HEALTH SYSTEM - ISLE CLINIC

Laboratory Demographics

CLIA Number: 24D0651637

Facility Name: MILLE LACS HEALTH SYSTEM - ISLE CLINIC

Facility Address:
375 WEST ISLE STREET
ISLE, MN
ZIP 56342
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Facility Phone Number: 320 532-2500

Facility Type: Community Clinic

Certificate Type: Certificate of Compliance

NPI Number: 1588067391

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	24D0651637
LAB Type	Community Clinic
Facility Name	MILLE LACS HEALTH SYSTEM - ISLE CLINIC
Street	375 WEST ISLE STREET
City	ISLE
State	MN
ZIP	56342
Phone	320 532-2500
CertificateType	2
CertificateEffectiveDate	3/12/2023
CertificateExpirationDate	3/11/2025
FacilityType	Compliance

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