24D2082934 CLIA NUMBER - JACKSON AMBULANCE SERVICE

Laboratory Demographics

  • CLIA Code: 24D2082934
  • Facility Name: JACKSON AMBULANCE SERVICE
  • Facility Address: 305 SHERIDAN ST
    JACKSON, MN
    ZIP 56143
  • Facility Phone: 507 840-0074
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: GRANT M. LANDBO
  • NPI Number: 1811915648
  • Taxonomy: 3416L0300X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 24D2082934
LAB Type Ambulance
Facility Name JACKSON AMBULANCE SERVICE
Street 305 SHERIDAN ST
City JACKSON
State MN
ZIP 56143
Phone 507 840-0074
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/26/2024
Certificate Expiration Date 8/25/2026
Facility Type Ambulance
Lab Director GRANT M. LANDBO

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