35D1062888 CLIA NUMBER - PORTAL AMBULANCE SERVICE

Laboratory Demographics

  • CLIA Code: 35D1062888
  • Facility Name: PORTAL AMBULANCE SERVICE
  • Facility Address: 301 CLARK STREET PO BOX 61
    PORTAL, ND
    ZIP 58772
  • Facility Phone: 701 839-6326
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: GERALD W. LOKKEN
  • NPI Number: 1962574848
  • Taxonomy: 3416L0300X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 35D1062888
LAB Type Ambulance
Facility Name PORTAL AMBULANCE SERVICE
Street 301 CLARK STREET PO BOX 61
City PORTAL
State ND
ZIP 58772
Phone 701 839-6326
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/29/2024
Certificate Expiration Date 12/28/2026
Facility Type Ambulance
Lab Director GERALD W. LOKKEN

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