24D0716060 CLIA NUMBER - NORTHSIDE MEDICAL CLINIC

Laboratory Demographics

  • CLIA Code: 24D0716060
  • Facility Name: NORTHSIDE MEDICAL CLINIC
  • Facility Address: 465 EASTVOLD AVENUE
    ORTONVILLE, MN
    ZIP 56278
  • Facility Phone: (320) 839-6157
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DAVID J. COLLINS
  • NPI Number: 1265401681
  • Taxonomy: 207Q00000X - Family Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 24D0716060
LAB Type Physician Office
Facility Name NORTHSIDE MEDICAL CLINIC
Street 465 EASTVOLD AVENUE
City ORTONVILLE
State MN
ZIP 56278
Phone 3208396157
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director DAVID J. COLLINS

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: 5/18/2026