35D2125986 CLIA NUMBER - BOTTINEAU AMBULANCE SERVICE

Laboratory Demographics

CLIA Number: 35D2125986

Facility Name: BOTTINEAU AMBULANCE SERVICE

Facility Address:
323 BENNETT ST
BOTTINEAU, ND
ZIP 58318
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Facility Phone Number: 701 228-6901

Facility Type: Ambulance

Certificate Type: Waiver

NPI Number: 1699817270

Taxonomy: 3416L0300X - Ambulance

CLIA Record

Field Name	Field Value
CLIA Number	35D2125986
LAB Type	Ambulance
Facility Name	BOTTINEAU AMBULANCE SERVICE
Street	323 BENNETT ST
City	BOTTINEAU
State	ND
ZIP	58318
Phone	701 228-6901
CertificateType	4
CertificateEffectiveDate	12/14/2023
CertificateExpirationDate	12/13/2025
FacilityType	Waiver

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