24D2060080 CLIA NUMBER - ALTRU CLINIC - EAST GRAND FORKS

Laboratory Demographics

  • CLIA Code: 24D2060080
  • Facility Name: ALTRU CLINIC - EAST GRAND FORKS
  • Facility Address: 607 DEMERS AVENUE
    EAST GRAND FORKS, MN
    ZIP 56721
  • Facility Phone: 701 780-5133
  • Facility Type: Ancillary Testing Site in Health Care Center
  • Facility Type: Waiver
  • Lab Director: HOLLY BERGH
  • NPI Number: 1740621556
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 24D2060080
LAB Type Ancillary Testing Site in Health Care Center
Facility Name ALTRU CLINIC - EAST GRAND FORKS
Street 607 DEMERS AVENUE
City EAST GRAND FORKS
State MN
ZIP 56721
Phone 701 780-5133
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/1/2025
Certificate Expiration Date 3/31/2027
Facility Type Ancillary Testing Site in Health Care Center
Lab Director HOLLY BERGH

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This page was last updated on: 6/4/2025