Organization
CENTRACARE HEALTH SYSTEMS
Active
Other names
CentraCare Laboratory Services
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL BLAIR (CFO)
(320) 255-5665
Entity
Organization
Contact information
Practice address
1406 6TH AVE NORTH, SAINT CLOUD, MN 56303-1900
(320) 251-2700
(320) 255-5711
Mailing address
1406 6TH AVE N, SAINT CLOUD, MN 56303-1900
(320) 251-2700
(320) 255-5711
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
24D0405788
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
443985600
—
MN
01
—
690009424
RR MEDICARE
MN
Enumeration date
05/10/2006
Last updated
01/26/2026
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