NPIMap

Organization Active NPI

Centracare Health Systems

Doing business as CentraCare Laboratory Services

  • Clinical Medical Laboratory
  • Saint Cloud, MN
National Provider Identifier
1326097833
Registry record updated Sep 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
24D0405788 Issued in MN
Legal business name
CENTRACARE HEALTH SYSTEMS
Doing business as
CentraCare Laboratory Services
Practice address
1406 6TH Ave North
Saint Cloud, MN 56303-1900
Phone
(320) 251-2700
Fax
(320) 255-5711
NPI assigned
May 10, 2006
Last updated
Sep 17, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Michael Blair
Title
Cfo
Phone
(320) 255-5665

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 24D0405788 MN Primary

Addresses

Primary practice location

1406 6TH Ave North
Saint Cloud, MN 56303-1900

Mailing address

PO Box 735816
Chicago, IL 60673-5816

Other identifiers 2

IdentifierTypeStateIssuer
443985600MedicaidMN
690009424OtherMNRR MEDICARE

Other names 1

  • CentraCare Laboratory Services Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051004000106 MN Part B Supplier - Independent Clinical Laboratory 8729990833 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Saint Cloud, MN

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
24D0405788Centracare Laboratory Services1406 - 6TH Ave N, Saint Cloud, MN 56303AccreditationFeb 8, 2027
24D0651612St Cloud Hospital Decentralized Lab1406 Sixth Ave North, Saint Cloud, MN 56303AccreditationJan 2, 2027

National Provider Directory

National Provider Directory
Tax ID family
Centracare Health System5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Member organizations 59

Organizations listed as members of this organization in the National Provider Directory.

View all 59

Practitioners & affiliated clinicians

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 20

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789603200000",
    "number": "1326097833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735816",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1406 6TH AVE NORTH",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563031900",
            "telephone_number": "320-251-2700",
            "fax_number": "320-255-5711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRACARE HEALTH SYSTEMS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-10",
        "last_updated": "2026-09-17",
        "certification_date": "2026-09-17",
        "status": "A",
        "authorized_official_last_name": "BLAIR",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "320-255-5665"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "MN",
            "license": "24D0405788",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "443985600",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "690009424",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CentraCare Laboratory Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Cloud, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.