24D2030769 CLIA NUMBER - MANKATO CLINIC DERMATOPATHOLOGY LAB

Laboratory Demographics

  • CLIA Code: 24D2030769
  • Facility Name: MANKATO CLINIC DERMATOPATHOLOGY LAB
  • Facility Address: 1400 MADISON AVE SUITE 352
    MANKATO, MN
    ZIP 56001
  • Facility Phone: 507 389-8634
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: DANIEL MILLER
  • NPI Number: 1265626964
  • Taxonomy: 363A00000X - Physician Assistant

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CLIA Record

Field Name Field Value
CLIA Number 24D2030769
LAB Type Physician Office
Facility Name MANKATO CLINIC DERMATOPATHOLOGY LAB
Street 1400 MADISON AVE SUITE 352
City MANKATO
State MN
ZIP 56001
Phone 507 389-8634
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 9/5/2024
Certificate Expiration Date 9/4/2026
Facility Type Physician Office
Lab Director DANIEL MILLER

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