24D2226036 CLIA NUMBER - PENNINGTON COUNTY JAIL

Laboratory Demographics

  • CLIA Code: 24D2226036
  • Facility Name: PENNINGTON COUNTY JAIL
  • Facility Address: 102 1ST STREET WEST
    THIEF RIVER FALLS, MN
    ZIP 56701
  • Facility Phone: 218 416-7097
  • Facility Type: Other - COUNTY JAIL
  • Facility Type: Waiver
  • Lab Director: DAVID CASANOVA
  • NPI Number: 1649594425
  • Taxonomy: 251B00000X - Case Management

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CLIA Record

Field Name Field Value
CLIA Number 24D2226036
LAB Type Other - COUNTY JAIL
Facility Name PENNINGTON COUNTY JAIL
Street 102 1ST STREET WEST
City THIEF RIVER FALLS
State MN
ZIP 56701
Phone 218 416-7097
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/26/2025
Certificate Expiration Date 5/25/2027
Facility Type Other - COUNTY JAIL
Lab Director DAVID CASANOVA

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