35D1051548 CLIA NUMBER - EVERGREEN PLACE

Laboratory Demographics

  • CLIA Code: 35D1051548
  • Facility Name: EVERGREEN PLACE
  • Facility Address: ATTN MICHELE THORPE 241 MAIN ST
    ELLENDALE, ND
    ZIP 58436
  • Facility Phone: 701 349-4550
  • Facility Type: Other
  • Facility Type: Waiver
  • Lab Director: MICHELE THORPE
  • NPI Number: 1538287263
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 35D1051548
LAB Type Other
Facility Name EVERGREEN PLACE
Street ATTN MICHELE THORPE 241 MAIN ST
City ELLENDALE
State ND
ZIP 58436
Phone 701 349-4550
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/6/2024
Certificate Expiration Date 3/5/2026
Facility Type Other
Lab Director MICHELE THORPE

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