24D2218161 CLIA NUMBER - PINE COUNTY JAIL

Laboratory Demographics

  • CLIA Code: 24D2218161
  • Facility Name: PINE COUNTY JAIL
  • Facility Address: 635 NORTHRIDGE DR NW #130
    PINE CITY, MN
    ZIP 55063
  • Facility Phone: 320 629-8403
  • Facility Type: Other - COUNTY JAIL CORRECTIONAL
  • Facility Type: Waiver
  • Lab Director: RODNEY WILLIAMSON
  • NPI Number: 1861849978
  • Taxonomy: 251K00000X - Public Health or Welfare

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CLIA Record

Field Name Field Value
CLIA Number 24D2218161
LAB Type Other - COUNTY JAIL CORRECTIONAL
Facility Name PINE COUNTY JAIL
Street 635 NORTHRIDGE DR NW #130
City PINE CITY
State MN
ZIP 55063
Phone 320 629-8403
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/26/2025
Certificate Expiration Date 3/25/2027
Facility Type Other - COUNTY JAIL CORRECTIONAL
Lab Director RODNEY WILLIAMSON

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