35D2171338 CLIA NUMBER - NORTHWEST BEHAVIORAL HEALTH CLINIC

Laboratory Demographics

  • CLIA Code: 35D2171338
  • Facility Name: NORTHWEST BEHAVIORAL HEALTH CLINIC
  • Facility Address: 316 2ND AVE W
    WILLISTON, ND
    ZIP 58801
  • Facility Phone: 701 774-4600
  • Facility Type: Other - PSYCH/ADDICTION OP CLINIC
  • Facility Type: Waiver
  • Lab Director: ADAM C. JANGULA
  • NPI Number: 1225051550
  • Taxonomy: 251C00000X - Day Training, Developmentally Disabled Services

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CLIA Record

Field Name Field Value
CLIA Number 35D2171338
LAB Type Other - PSYCH/ADDICTION OP CLINIC
Facility Name NORTHWEST BEHAVIORAL HEALTH CLINIC
Street 316 2ND AVE W
City WILLISTON
State ND
ZIP 58801
Phone 701 774-4600
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/29/2025
Certificate Expiration Date 8/28/2027
Facility Type Other - PSYCH/ADDICTION OP CLINIC
Lab Director ADAM C. JANGULA

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