35D2200309 CLIA NUMBER - FARGO ELIM ASSISTED LIVING

Laboratory Demographics

  • CLIA Code: 35D2200309
  • Facility Name: FARGO ELIM ASSISTED LIVING
  • Facility Address: 3540 UNIVERSITY DR S
    FARGO, ND
    ZIP 58104
  • Facility Phone: 701 271-1801
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: HANNAH WAGEMANN
  • NPI Number: 1548915697
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 35D2200309
LAB Type Assisted Living Facility
Facility Name FARGO ELIM ASSISTED LIVING
Street 3540 UNIVERSITY DR S
City FARGO
State ND
ZIP 58104
Phone 701 271-1801
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/14/2024
Certificate Expiration Date 11/13/2026
Facility Type Assisted Living Facility
Lab Director HANNAH WAGEMANN

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