35D2104644 CLIA NUMBER - EVENTIDE FARGO

Laboratory Demographics

  • CLIA Code: 35D2104644
  • Facility Name: EVENTIDE FARGO
  • Facility Address: 3225 51ST ST S
    FARGO, ND
    ZIP 58104
  • Facility Phone: (701) 478-1800
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: SHARILYN ALTHOFF
  • NPI Number: 1164809562
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 35D2104644
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name EVENTIDE FARGO
Street 3225 51ST ST S
City FARGO
State ND
ZIP 58104
Phone 7014781800
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/10/2025
Certificate Expiration Date 11/9/2027
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director SHARILYN ALTHOFF

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