24D2288466 CLIA NUMBER - HOMEWARD PHYSICIANS, PLLC

Laboratory Demographics

CLIA Number: 24D2288466

Facility Name: HOMEWARD PHYSICIANS, PLLC

Facility Address:
804 16TH STREET
MONTEVIDEO, MN
ZIP 56265
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Facility Phone Number: 844 670-2273

Facility Type: Mobile Laboratory

Certificate Type: Waiver

NPI Number: 1538828314

Taxonomy: 208D00000X - General Practice
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

CLIA Record

Field Name	Field Value
CLIA Number	24D2288466
LAB Type	Mobile Laboratory
Facility Name	HOMEWARD PHYSICIANS, PLLC
Street	804 16TH STREET
City	MONTEVIDEO
State	MN
ZIP	56265
Phone	844 670-2273
CertificateType	4
CertificateEffectiveDate	8/25/2023
CertificateExpirationDate	8/24/2025
FacilityType	Waiver

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