35D0409019 CLIA NUMBER - UNDERWOOD CLINIC PC

Laboratory Demographics

  • CLIA Code: 35D0409019
  • Facility Name: UNDERWOOD CLINIC PC
  • Facility Address: 87 LINCOLN AVE
    UNDERWOOD, ND
    ZIP 58576
  • Facility Phone: 701 442-3148
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: MICHELE D. LEIDHOLM
  • NPI Number: 1770591927
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 35D0409019
LAB Type Community Clinic
Facility Name UNDERWOOD CLINIC PC
Street 87 LINCOLN AVE
City UNDERWOOD
State ND
ZIP 58576
Phone 701 442-3148
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/1/2023
Certificate Expiration Date 11/30/2025
Facility Type Community Clinic
Lab Director MICHELE D. LEIDHOLM

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