35D2022940 CLIA NUMBER - STELLAR HEALTHCARE

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Laboratory Demographics

CLIA Number: 35D2022940

Facility Name: STELLAR HEALTHCARE

Facility Address:
3274 51ST ST S
FARGO, ND
ZIP 58104
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Facility Phone Number: 701 364-3660

Facility Type: Practitioner Other

Certificate Type: Waiver

NPI Number: 1760781033

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	35D2022940
LAB Type	Practitioner Other
Facility Name	STELLAR HEALTHCARE
Street	3274 51ST ST S
City	FARGO
State	ND
ZIP	58104
Phone	701 364-3660
CertificateType	4
CertificateEffectiveDate	4/13/2023
CertificateExpirationDate	4/12/2025
FacilityType	Waiver

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