24D2178337 CLIA NUMBER - NYSTROM AND ASSOCIATES

Laboratory Demographics

  • CLIA Code: 24D2178337
  • Facility Name: NYSTROM AND ASSOCIATES
  • Facility Address: 207 JEFFERSON BLVD
    BIG LAKE, MN
    ZIP 55309
  • Facility Phone: 651 628-9566
  • Facility Type: Comp. Outpatient Rehab Facility
  • Facility Type: Waiver
  • Lab Director: JONATHAN C. UECKER
  • NPI Number: 1396750188
  • Taxonomy: 1041C0700X - Social Worker

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CLIA Record

Field Name Field Value
CLIA Number 24D2178337
LAB Type Comp. Outpatient Rehab Facility
Facility Name NYSTROM AND ASSOCIATES
Street 207 JEFFERSON BLVD
City BIG LAKE
State MN
ZIP 55309
Phone 651 628-9566
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/31/2024
Certificate Expiration Date 1/30/2026
Facility Type Comp. Outpatient Rehab Facility
Lab Director JONATHAN C. UECKER

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