35D0409312 CLIA NUMBER - TRINITY COMMUNITY CLINIC-WESTERN DAKOTA

Laboratory Demographics

  • CLIA Code: 35D0409312
  • Facility Name: TRINITY COMMUNITY CLINIC-WESTERN DAKOTA
  • Facility Address: 1321 W DAKOTA PARKWAY
    WILLISTON, ND
    ZIP 58801
  • Facility Phone: 701 572-7711
  • Facility Type: Community Clinic
  • Facility Type: Accreditation
  • Lab Director: DR. WAYNE L. JANSEN
  • NPI Number: 1396784146
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 35D0409312
LAB Type Community Clinic
Facility Name TRINITY COMMUNITY CLINIC-WESTERN DAKOTA
Street 1321 W DAKOTA PARKWAY
City WILLISTON
State ND
ZIP 58801
Phone 701 572-7711
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 1/11/2024
Certificate Expiration Date 1/10/2026
Facility Type Community Clinic
Lab Director DR. WAYNE L. JANSEN

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This page was last updated on: 3/20/2025