35D2247496 CLIA NUMBER - LIVING WELL DAKOTA

Laboratory Demographics

  • CLIA Code: 35D2247496
  • Facility Name: LIVING WELL DAKOTA
  • Facility Address: 1140 W CAPITOL AVE
    BISMARCK, ND
    ZIP 58501
  • Facility Phone: 701 204-7706
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JODY TANNER
  • NPI Number: 1619647211
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 35D2247496
LAB Type Physician Office
Facility Name LIVING WELL DAKOTA
Street 1140 W CAPITOL AVE
City BISMARCK
State ND
ZIP 58501
Phone 701 204-7706
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/6/2024
Certificate Expiration Date 1/5/2026
Facility Type Physician Office
Lab Director JODY TANNER

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