35D2206901 CLIA NUMBER - MINOT VOCATIONAL ADJUSTMENT WORKSHOP DBA KALIX

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Laboratory Demographics

CLIA Number: 35D2206901

Facility Name: MINOT VOCATIONAL ADJUSTMENT WORKSHOP DBA KALIX

Facility Address:
605 27TH ST SE
MINOT, ND
ZIP 58701
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Facility Phone Number: 701 852-1014

Facility Type: Intermediate Care Facility for Mentally Retarded

Certificate Type: Waiver

NPI Number: 1730248238

Taxonomy: 315P00000X - Intermediate Care Facility, Intellectual Disabilities
An intermediate care facility providing services for individuals with intellectual disabilities.

CLIA Record

Field Name	Field Value
CLIA Number	35D2206901
LAB Type	Intermediate Care Facility for Mentally Retarded
Facility Name	MINOT VOCATIONAL ADJUSTMENT WORKSHOP DBA KALIX
Street	605 27TH ST SE
City	MINOT
State	ND
ZIP	58701
Phone	701 852-1014
CertificateType	4
CertificateEffectiveDate	12/23/2022
CertificateExpirationDate	12/22/2024
FacilityType	Waiver

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