24D2292639 CLIA NUMBER - CCM HEALTH - MARSHALL

Laboratory Demographics

  • CLIA Code: 24D2292639
  • Facility Name: CCM HEALTH - MARSHALL
  • Facility Address: 1401 NWAKAMA STREET SUITE 100
    MARSHALL, MN
    ZIP 56258
  • Facility Phone: 320 321-8261
  • Facility Type: Rural Health Clinic
  • Facility Type: Waiver
  • Lab Director: TAMMY M. BENTLEY
  • NPI Number: 1487436655
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 24D2292639
LAB Type Rural Health Clinic
Facility Name CCM HEALTH - MARSHALL
Street 1401 NWAKAMA STREET SUITE 100
City MARSHALL
State MN
ZIP 56258
Phone 320 321-8261
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/27/2023
Certificate Expiration Date 10/26/2025
Facility Type Rural Health Clinic
Lab Director TAMMY M. BENTLEY

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