24D1106358 CLIA NUMBER - RANGE CENTER INC

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Field Name	Field Value
CLIA Number	24D1106358
LAB Type	Intermediate Care Facility for Mentally Retarded
Facility Name	RANGE CENTER INC
Street	1001 NW 8TH AVENUE
City	CHISHOLM
State	MN
ZIP	55719
Phone	218 254-3347
Certificate Type	Certificate of Waiver
Certificate Type Description	This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date	10/12/2025
Certificate Expiration Date	10/11/2027
Facility Type	Intermediate Care Facility for Mentally Retarded
Lab Director	KRYSTLE GLAD

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