24D1040567 CLIA NUMBER - GOLDPINE HOME

Laboratory Demographics

  • CLIA Code: 24D1040567
  • Facility Name: GOLDPINE HOME
  • Facility Address: 1700 30TH ST NW
    BEMIDJI, MN
    ZIP 56601
  • Facility Phone: 218 444-4346
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: CLARISSA M. DOWHOWER
  • NPI Number: 1245576073
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 24D1040567
LAB Type Assisted Living Facility
Facility Name GOLDPINE HOME
Street 1700 30TH ST NW
City BEMIDJI
State MN
ZIP 56601
Phone 218 444-4346
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/11/2025
Certificate Expiration Date 5/10/2027
Facility Type Assisted Living Facility
Lab Director CLARISSA M. DOWHOWER

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