CLIA lab
CLIA 24D2264643: Northern Lakes Surgery Center LLC
Moose Lake, MN. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 24D2264643 belongs to Northern Lakes Surgery Center LLC in Moose Lake, MN.
Certificate of Waiver, effective July 18, 2026, expires July 17, 2028.
Active in the CMS Provider of Services file posted October 16, 2026.
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
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Certificate
- Certificate type
- Certificate of Waiver
- Certificate effective
- July 18, 2026
- Certificate expiration
- July 17, 2028
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- July 18, 2022
- Facility type
- Ambulatory surgery center
- Ownership (control type)
- Private
- Lab classification
- CLIA laboratory
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 24D2264643
- Lab name
- Northern Lakes Surgery Center LLC
- Address
- 4791 County Road 10 Ste 101, Moose Lake, MN 55767
- Phone
- (218) 249-5357
Annual test volume the lab reported
- Waived tests
- 300
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Other labs in Moose Lake, MN
- Aspirus ST Luke's Diagnostic Imaging Moose LakeCertificate of Waiver, Other24D2288457
- Augustana Mercy Care CenterCertificate of Waiver, Skilled nursing or nursing facility24D2008435
- Essentia Health Moose LakeCertificate of Accreditation, Hospital24D0651464
- Gateway Family Health Clinic, LTDCertificate of Accreditation, Physician office24D0403786
- Kenwood PlaceCertificate of Waiver, Skilled nursing or nursing facility24D2007522
- Minnesota Correctional FacilityCertificate of Waiver, Ambulance24D1002313
- Minnesota Sex Offender ProgramCertificate of Waiver, Other24D0975545
- Moose Lake Community SchoolCertificate of Waiver, School or student health service24D2241825
- Moose Lake Eye CareCertificate of Waiver, Physician office24D2093833
- Oakview Assisted Living FacilityCertificate of Waiver, Assisted living facility24D1049875
Related
Questions
What is the CLIA number for Northern Lakes Surgery Center LLC in Moose Lake?
24D2264643, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Northern Lakes Surgery Center LLC hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 24D2264643 expire?
The CMS file lists July 17, 2028 as the certificate expiration date; the certificate took effect July 18, 2026.