24D2159579 CLIA NUMBER - AVERA MEDICAL GROUP CARLSON (COAG CLINIC)

Laboratory Demographics

  • CLIA Code: 24D2159579
  • Facility Name: AVERA MEDICAL GROUP CARLSON (COAG CLINIC)
  • Facility Address: 1521 CARLSON STREET
    MARSHALL, MN
    ZIP 56258
  • Facility Phone: 507 476-4800
  • Facility Type: Other - COUMADIN CLINIC
  • Facility Type: Waiver
  • Lab Director: STEVEN MEISTER
  • NPI Number: 1700429644
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 24D2159579
LAB Type Other - COUMADIN CLINIC
Facility Name AVERA MEDICAL GROUP CARLSON (COAG CLINIC)
Street 1521 CARLSON STREET
City MARSHALL
State MN
ZIP 56258
Phone 507 476-4800
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/20/2024
Certificate Expiration Date 12/19/2026
Facility Type Other - COUMADIN CLINIC
Lab Director STEVEN MEISTER

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