24D2267203 CLIA NUMBER - CENTRACARE COMMUNITY HEALTH

Laboratory Demographics

CLIA Number: 24D2267203

Facility Name: CENTRACARE COMMUNITY HEALTH

Facility Address:
3001 CLEARWATER RD
SAINT CLOUD, MN
ZIP 56301
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Facility Phone Number: 320 492-8376

Facility Type: Other - TEMPORARY TESTING SITES

Certificate Type: Waiver

NPI Number: 1366192759

Taxonomy: 261QX0100X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	24D2267203
LAB Type	Other - TEMPORARY TESTING SITES
Facility Name	CENTRACARE COMMUNITY HEALTH
Street	3001 CLEARWATER RD
City	SAINT CLOUD
State	MN
ZIP	56301
Phone	320 492-8376
CertificateType	4
CertificateEffectiveDate	8/22/2022
CertificateExpirationDate	8/21/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024