35D2028876 CLIA NUMBER - TRINITY ORAL AND FACIAL SURGERY

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Laboratory Demographics

CLIA Number: 35D2028876

Facility Name: TRINITY ORAL AND FACIAL SURGERY

Facility Address:
2815 16TH ST SW SUITE #100
MINOT, ND
ZIP 58701
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Facility Phone Number: 701 857-2900

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1245272277

Taxonomy: 261QS0112X - Clinic/Center
An oral and maxillofacial surgery clinic or center specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.

CLIA Record

Field Name	Field Value
CLIA Number	35D2028876
LAB Type	Physician Office
Facility Name	TRINITY ORAL AND FACIAL SURGERY
Street	2815 16TH ST SW SUITE #100
City	MINOT
State	ND
ZIP	58701
Phone	701 857-2900
CertificateType	4
CertificateEffectiveDate	8/25/2023
CertificateExpirationDate	8/24/2025
FacilityType	Waiver

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