35D2131784 CLIA NUMBER - NORTHLAND HEALTH PARTNERS COMMUNITY HEALTH CENTERS

Laboratory Demographics

CLIA Number: 35D2131784

Facility Name: NORTHLAND HEALTH PARTNERS COMMUNITY HEALTH CENTERS

Facility Address:
914 S 12TH ST SUITE 101
BISMARCK, ND
ZIP 58504
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Facility Phone Number: 701 448-2054

Facility Type: Federally Qualified Health Center

Certificate Type: Waiver

NPI Number: 1841723855

Taxonomy: 261QF0400X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	35D2131784
LAB Type	Federally Qualified Health Center
Facility Name	NORTHLAND HEALTH PARTNERS COMMUNITY HEALTH CENTERS
Street	914 S 12TH ST SUITE 101
City	BISMARCK
State	ND
ZIP	58504
Phone	701 448-2054
CertificateType	4
CertificateEffectiveDate	6/6/2023
CertificateExpirationDate	6/5/2025
FacilityType	Waiver

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