35D1011929 CLIA NUMBER - SARGENT COUNTY AMBULANCE/FORMAN

Laboratory Demographics

  • CLIA Code: 35D1011929
  • Facility Name: SARGENT COUNTY AMBULANCE/FORMAN
  • Facility Address: 355 MAIN ST S
    FORMAN, ND
    ZIP 58032
  • Facility Phone: (701) 724-3385
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: MARWOOD KLEIN
  • NPI Number: 1265514756
  • Taxonomy: 3416L0300X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 35D1011929
LAB Type Ambulance
Facility Name SARGENT COUNTY AMBULANCE/FORMAN
Street 355 MAIN ST S
City FORMAN
State ND
ZIP 58032
Phone 7017243385
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/22/2024
Certificate Expiration Date 6/21/2026
Facility Type Ambulance
Lab Director MARWOOD KLEIN

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This page was last updated on: 5/18/2026