35D2123268 CLIA NUMBER - FOUR SEASONS WELLNESS, PLLC

Laboratory Demographics

  • CLIA Code: 35D2123268
  • Facility Name: FOUR SEASONS WELLNESS, PLLC
  • Facility Address: 110 W BROADWAY
    STEELE, ND
    ZIP 58482
  • Facility Phone: 701 475-4488
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: MANDI J. MOCK
  • NPI Number: 1366992323
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 35D2123268
LAB Type Practitioner Other
Facility Name FOUR SEASONS WELLNESS, PLLC
Street 110 W BROADWAY
City STEELE
State ND
ZIP 58482
Phone 701 475-4488
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/15/2024
Certificate Expiration Date 12/14/2026
Facility Type Practitioner Other
Lab Director MANDI J. MOCK

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