24D2245821 CLIA NUMBER - MINNESOTA STATE ACADEMIES DISTRICT 0160

Laboratory Demographics

  • CLIA Code: 24D2245821
  • Facility Name: MINNESOTA STATE ACADEMIES DISTRICT 0160
  • Facility Address: 615 OLOF HANSON DRIVE
    FARIBAULT, MN
    ZIP 55021
  • Facility Phone: 507 384-6611
  • Facility Type: School/Student Health Service
  • Facility Type: Waiver
  • Lab Director: KIMBERLY C. VISKOCIL
  • NPI Number: 1083108013
  • Taxonomy: 261QP2000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 24D2245821
LAB Type School/Student Health Service
Facility Name MINNESOTA STATE ACADEMIES DISTRICT 0160
Street 615 OLOF HANSON DRIVE
City FARIBAULT
State MN
ZIP 55021
Phone 507 384-6611
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/16/2023
Certificate Expiration Date 12/15/2025
Facility Type School/Student Health Service
Lab Director KIMBERLY C. VISKOCIL

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