24D1035155 CLIA NUMBER - HOYT LAKES AMBULANCE

Laboratory Demographics

CLIA Number: 24D1035155

Facility Name: HOYT LAKES AMBULANCE

Facility Address:
206 KENNEDY MEMORIAL DRIVE
HOYT LAKES, MN
ZIP 55750
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Facility Phone Number: 218 225-2110

Facility Type: Ambulance

Certificate Type: Waiver

NPI Number: 1659312890

Taxonomy: 3416L0300X - Ambulance

CLIA Record

Field Name	Field Value
CLIA Number	24D1035155
LAB Type	Ambulance
Facility Name	HOYT LAKES AMBULANCE
Street	206 KENNEDY MEMORIAL DRIVE
City	HOYT LAKES
State	MN
ZIP	55750
Phone	218 225-2110
CertificateType	4
CertificateEffectiveDate	12/21/2022
CertificateExpirationDate	12/20/2024
FacilityType	Waiver

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