24D1082802 CLIA NUMBER - MOORHEAD MANOR

Laboratory Demographics

  • CLIA Code: 24D1082802
  • Facility Name: MOORHEAD MANOR
  • Facility Address: 1710 - 13TH AVE NORTH
    MOORHEAD, MN
    ZIP 56560
  • Facility Phone: 218 236-6286
  • Facility Type: Other
  • Facility Type: Waiver
  • Lab Director: SUSAN D. CHRISTIANSON
  • NPI Number: 1679110969
  • Taxonomy: 1041C0700X - Social Worker

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 24D1082802
LAB Type Other
Facility Name MOORHEAD MANOR
Street 1710 - 13TH AVE NORTH
City MOORHEAD
State MN
ZIP 56560
Phone 218 236-6286
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/18/2024
Certificate Expiration Date 4/17/2026
Facility Type Other
Lab Director SUSAN D. CHRISTIANSON

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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