24D0947932 CLIA NUMBER - IVERSON CORNER DRUG INC

Laboratory Demographics

  • CLIA Code: 24D0947932
  • Facility Name: IVERSON CORNER DRUG INC
  • Facility Address: 408 MINNESOTA AVE NW
    BEMIDJI, MN
    ZIP 56601
  • Facility Phone: 218 444-3000
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: PAUL S. IVERSON
  • NPI Number: 1184723611
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D0947932
LAB Type Pharmacy
Facility Name IVERSON CORNER DRUG INC
Street 408 MINNESOTA AVE NW
City BEMIDJI
State MN
ZIP 56601
Phone 218 444-3000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/26/2024
Certificate Expiration Date 6/25/2026
Facility Type Pharmacy
Lab Director PAUL S. IVERSON

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This page was last updated on: 9/29/2025