24D2179329 CLIA NUMBER - NORTHFIELD HOSPITAL & CLINICS - FARIBAULT CLINIC

Laboratory Demographics

  • CLIA Code: 24D2179329
  • Facility Name: NORTHFIELD HOSPITAL & CLINICS - FARIBAULT CLINIC
  • Facility Address: 1980 30TH STREET NW
    FARIBAULT, MN
    ZIP 55021
  • Facility Phone: 507 646-8212
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MARY JO BLOOFLAT
  • NPI Number: 1588112098
  • Taxonomy: 261QM1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 24D2179329
LAB Type Physician Office
Facility Name NORTHFIELD HOSPITAL & CLINICS - FARIBAULT CLINIC
Street 1980 30TH STREET NW
City FARIBAULT
State MN
ZIP 55021
Phone 507 646-8212
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/20/2024
Certificate Expiration Date 2/19/2026
Facility Type Physician Office
Lab Director MARY JO BLOOFLAT

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