24D1063965 CLIA NUMBER - BIGFORK VALLEY ASSISTED LIVING

Laboratory Demographics

  • CLIA Code: 24D1063965
  • Facility Name: BIGFORK VALLEY ASSISTED LIVING
  • Facility Address: 258 PINE TREE DRIVE
    BIGFORK, MN
    ZIP 56628
  • Facility Phone: 218 743-1004
  • Facility Type: Other
  • Facility Type: Waiver
  • Lab Director: JILLIAN HAATAJA
  • NPI Number: 1487797544
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D1063965
LAB Type Other
Facility Name BIGFORK VALLEY ASSISTED LIVING
Street 258 PINE TREE DRIVE
City BIGFORK
State MN
ZIP 56628
Phone 218 743-1004
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/25/2025
Certificate Expiration Date 1/24/2027
Facility Type Other
Lab Director JILLIAN HAATAJA

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