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24D2023711 CLIA NUMBER - ST CROIX HOSPICE NORTH BRANCH

Laboratory Demographics

CLIA Number: 24D2023711

Facility Name: ST CROIX HOSPICE NORTH BRANCH

Facility Address:
6041 MAIN STREET SUITE G
NORTH BRANCH, MN
ZIP 55056
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Facility Phone Number: 763 689-3735

Facility Type: Hospice

Certificate Type: Waiver
NPI Number: 1235601121

Taxonomy: 251300000X - Local Education Agency (LEA)
The term local education agency means a public board of education or other public authority legally constituted within a State to either provide administrative control or direction of, or perform a service function for public schools serving individuals ages 0 - 21 in a state, city, county, township, school district, or other political subdivision including a combination of school districts or counties recognized in a State as an administrative agency for its public schools. An LEA may provide, or employ professional who provide, services to children included in the Individuals with Disabilities Education Act (IDEA), such services may include, but are not limited to, such medical services as physical, occupational, and speech therapy.

CLIA Record

Field Name Field Value
CLIA Number 24D2023711
LAB Type Hospice
Facility Name ST CROIX HOSPICE NORTH BRANCH
Street 6041 MAIN STREET SUITE G
City NORTH BRANCH
State MN
ZIP 55056
Phone 763 689-3735
CertificateType 4
CertificateEffectiveDate 4/29/2023
CertificateExpirationDate 4/28/2025
FacilityType Waiver

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This page was last updated on: 4/23/2024