24D2128913 CLIA NUMBER - NORTHERN EYE CENTER PA

Laboratory Demographics

CLIA Number: 24D2128913

Facility Name: NORTHERN EYE CENTER PA

Facility Address:
119 1ST STREET NE
LITTLE FALLS, MN
ZIP 56345
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Facility Phone Number: 320 632-2391

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1225168602

Taxonomy: 251S00000X - Community/Behavioral Health
A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.

CLIA Record

Field Name	Field Value
CLIA Number	24D2128913
LAB Type	Physician Office
Facility Name	NORTHERN EYE CENTER PA
Street	119 1ST STREET NE
City	LITTLE FALLS
State	MN
ZIP	56345
Phone	320 632-2391
CertificateType	4
CertificateEffectiveDate	4/10/2023
CertificateExpirationDate	4/9/2025
FacilityType	Waiver

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