35D2297875 CLIA NUMBER - ESSENTIAL FAMILY SOLUTIONS

Laboratory Demographics

CLIA Number: 35D2297875

Facility Name: ESSENTIAL FAMILY SOLUTIONS

Facility Address:
104 11TH ST W, STE 6
BOTTINEAU, ND
ZIP 58318
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Facility Phone Number: 701 228-3326

Facility Type: Other - MENTAL HEALTH/ADDICTIONS

Certificate Type: Waiver

NPI Number: 1770215873

Taxonomy: 261QM0801X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	35D2297875
LAB Type	Other - MENTAL HEALTH/ADDICTIONS
Facility Name	ESSENTIAL FAMILY SOLUTIONS
Street	104 11TH ST W, STE 6
City	BOTTINEAU
State	ND
ZIP	58318
Phone	701 228-3326
CertificateType	4
CertificateEffectiveDate	1/24/2024
CertificateExpirationDate	1/23/2026
FacilityType	Waiver

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