24D1089080 CLIA NUMBER - ESSENTIA HEALTH - DOWNTOWN MOORHEAD

Laboratory Demographics

  • CLIA Code: 24D1089080
  • Facility Name: ESSENTIA HEALTH - DOWNTOWN MOORHEAD
  • Facility Address: 720 MAIN AVE
    MOORHEAD, MN
    ZIP 56560
  • Facility Phone: 701 364-7342
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: AMANDA J. BUETTNER
  • NPI Number: 1790931467
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 24D1089080
LAB Type Physician Office
Facility Name ESSENTIA HEALTH - DOWNTOWN MOORHEAD
Street 720 MAIN AVE
City MOORHEAD
State MN
ZIP 56560
Phone 701 364-7342
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/10/2024
Certificate Expiration Date 9/9/2026
Facility Type Physician Office
Lab Director AMANDA J. BUETTNER

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