35D0409334 CLIA NUMBER - MCKENZIE COUNTY HEALTHCARE SYS/CLINIC

Laboratory Demographics

CLIA Number: 35D0409334

Facility Name: MCKENZIE COUNTY HEALTHCARE SYS/CLINIC

Facility Address:
709 4TH AVE NE
WATFORD CITY, ND
ZIP 58854
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Facility Phone Number: 701 842-3771

Facility Type: Community Clinic

Certificate Type: Waiver

NPI Number: 1457374217

Taxonomy: 261QR1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	35D0409334
LAB Type	Community Clinic
Facility Name	MCKENZIE COUNTY HEALTHCARE SYS/CLINIC
Street	709 4TH AVE NE
City	WATFORD CITY
State	ND
ZIP	58854
Phone	701 842-3771
CertificateType	4
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	Waiver

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