24D1047834 CLIA NUMBER - OTTERTAIL AREA MEDICAL CLINIC

Laboratory Demographics

  • CLIA Code: 24D1047834
  • Facility Name: OTTERTAIL AREA MEDICAL CLINIC
  • Facility Address: 232 MN HWY 78 N
    OTTERTAIL, MN
    ZIP 56571
  • Facility Phone: 218 631-7502
  • Facility Type: Rural Health Clinic
  • Facility Type: Waiver
  • Lab Director: TONYA A. BEULKE
  • NPI Number: 1871546663
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 24D1047834
LAB Type Rural Health Clinic
Facility Name OTTERTAIL AREA MEDICAL CLINIC
Street 232 MN HWY 78 N
City OTTERTAIL
State MN
ZIP 56571
Phone 218 631-7502
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/25/2024
Certificate Expiration Date 4/24/2026
Facility Type Rural Health Clinic
Lab Director TONYA A. BEULKE

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