24D2264180 CLIA NUMBER - SELAH WELLNESS CLINIC LLC

Laboratory Demographics

  • CLIA Code: 24D2264180
  • Facility Name: SELAH WELLNESS CLINIC LLC
  • Facility Address: 501 MAIN STREET
    SANDSTONE, MN
    ZIP 55072
  • Facility Phone: 320 372-2323
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: NAOMI J. KOENIG
  • NPI Number: 1215676747
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 24D2264180
LAB Type Practitioner Other
Facility Name SELAH WELLNESS CLINIC LLC
Street 501 MAIN STREET
City SANDSTONE
State MN
ZIP 55072
Phone 320 372-2323
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/12/2024
Certificate Expiration Date 7/11/2026
Facility Type Practitioner Other
Lab Director NAOMI J. KOENIG

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