35D2190308 CLIA NUMBER - PROSPERITY HEALTH PHARMACY

Laboratory Demographics

  • CLIA Code: 35D2190308
  • Facility Name: PROSPERITY HEALTH PHARMACY
  • Facility Address: 5180 PROSPERITY WAY S SUITE 106
    FARGO, ND
    ZIP 58104
  • Facility Phone: 701 951-7979
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: VIRGINIA T. HOWE
  • NPI Number: 1992345391
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 35D2190308
LAB Type Pharmacy
Facility Name PROSPERITY HEALTH PHARMACY
Street 5180 PROSPERITY WAY S SUITE 106
City FARGO
State ND
ZIP 58104
Phone 701 951-7979
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/12/2024
Certificate Expiration Date 8/11/2026
Facility Type Pharmacy
Lab Director VIRGINIA T. HOWE

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