24D0927853 CLIA NUMBER - CENTRACARE - BECKER CLINIC

Laboratory Demographics

CLIA Number: 24D0927853

Facility Name: CENTRACARE - BECKER CLINIC

Facility Address:
12800 ROLLING RIDGE ROAD
BECKER, MN
ZIP 55308
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Facility Phone Number: 763 271-2819

Facility Type: Physician Office

Certificate Type: Certificate of Compliance

NPI Number: 1710048590

Taxonomy: 261QM1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	24D0927853
LAB Type	Physician Office
Facility Name	CENTRACARE - BECKER CLINIC
Street	12800 ROLLING RIDGE ROAD
City	BECKER
State	MN
ZIP	55308
Phone	763 271-2819
CertificateType	2
CertificateEffectiveDate	6/26/2023
CertificateExpirationDate	6/25/2025
FacilityType	Compliance

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