24D2113157 CLIA NUMBER - DOUGLAS HEALTH

Laboratory Demographics

  • CLIA Code: 24D2113157
  • Facility Name: DOUGLAS HEALTH
  • Facility Address: 119 30TH AVE W
    ALEXANDRIA, MN
    ZIP 56308
  • Facility Phone: 320 762-6226
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: MICHAEL L. COWAN
  • NPI Number: 1932162112
  • Taxonomy: 103T00000X - Psychologist

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CLIA Record

Field Name Field Value
CLIA Number 24D2113157
LAB Type Practitioner Other
Facility Name DOUGLAS HEALTH
Street 119 30TH AVE W
City ALEXANDRIA
State MN
ZIP 56308
Phone 320 762-6226
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/17/2024
Certificate Expiration Date 5/16/2026
Facility Type Practitioner Other
Lab Director MICHAEL L. COWAN

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