24D2016540 CLIA NUMBER - KURTIS WATERS MD PA

Laboratory Demographics

  • CLIA Code: 24D2016540
  • Facility Name: KURTIS WATERS MD PA
  • Facility Address: 13359 ISLE DRIVE, SUITE 1
    BAXTER, MN
    ZIP 56425
  • Facility Phone: 218 454-8888
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: KURTIS A. WATERS
  • NPI Number: 1568440717
  • Taxonomy: 207Y00000X - Otolaryngology

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CLIA Record

Field Name Field Value
CLIA Number 24D2016540
LAB Type Physician Office
Facility Name KURTIS WATERS MD PA
Street 13359 ISLE DRIVE, SUITE 1
City BAXTER
State MN
ZIP 56425
Phone 218 454-8888
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 11/19/2024
Certificate Expiration Date 11/18/2026
Facility Type Physician Office
Lab Director KURTIS A. WATERS

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