Organization
CENTRACARE HEALTH SYSTEM
Active
Parent organization
CENTRACARE HEALTH SYSTEMS
Other names
CentraCare Laboratory Services
Organization subpart
Yes
Provider details
NPI number
Legal business name
CENTRACARE HEALTH SYSTEMS
Authorized official
MICHAEL BLAIR (CFO)
(320) 251-2700
Entity
Organization
Contact information
Practice address
1900 CENTRACARE CIR, CENTRACARE HEALTH PLAZA, SAINT CLOUD, MN 56303-5000
(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
24D0405790
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
24DO405790
CLIA
MN
05
—
443985600
—
MN
01
—
690009424
RR MEDICARE
MN
Enumeration date
05/05/2006
Last updated
11/10/2025
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