35D0969733 CLIA NUMBER - GATEWAY PHARMACY MANDAN

Laboratory Demographics

  • CLIA Code: 35D0969733
  • Facility Name: GATEWAY PHARMACY MANDAN
  • Facility Address: 500 BURLINGTON ST SE
    MANDAN, ND
    ZIP 58554
  • Facility Phone: 701 667-1843
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: COLE PETERSON
  • NPI Number: 1497847776
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 35D0969733
LAB Type Pharmacy
Facility Name GATEWAY PHARMACY MANDAN
Street 500 BURLINGTON ST SE
City MANDAN
State ND
ZIP 58554
Phone 701 667-1843
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/25/2024
Certificate Expiration Date 1/24/2026
Facility Type Pharmacy
Lab Director COLE PETERSON

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