24D2066793 CLIA NUMBER - ESSENTIA HEALTH ST MARY'S - FRAZEE CLINIC

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Laboratory Demographics

CLIA Number: 24D2066793

Facility Name: ESSENTIA HEALTH ST MARY'S - FRAZEE CLINIC

Facility Address:
300 MAIN AVE EAST
FRAZEE, MN
ZIP 56544
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Facility Phone Number: 701 364-8714

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1275977928

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	24D2066793
LAB Type	Physician Office
Facility Name	ESSENTIA HEALTH ST MARY'S - FRAZEE CLINIC
Street	300 MAIN AVE EAST
City	FRAZEE
State	MN
ZIP	56544
Phone	701 364-8714
CertificateType	4
CertificateEffectiveDate	10/3/2023
CertificateExpirationDate	10/2/2025
FacilityType	Waiver

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