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Sanford Health of Northern Minnesota

Organization Active NPI Clinical Medical Laboratory · Bemidji, MN

NPI 1508922758 · NPPES record last updated Nov 27, 2023

Key facts

NPI
1508922758
Entity type
Organization (NPI type 2)
Primary specialty
Clinical Medical Laboratory 291U00000X
Legal business name
SANFORD HEALTH OF NORTHERN MINNESOTA
Practice address
1300 Anne St NW
Bemidji, MN 56601-5103
Phone
(218) 333-5000
NPI assigned
Dec 29, 2006
Organization subpart
No

Authorized official

Name
Tony Lee Morrison
Title
Vice President, Revenue Cycle
Phone
(605) 328-8380

Other NPIs with the same Medicare PAC ID 20

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 22

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

Practitioners 349

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 349

Laboratory certificates & supplier records

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
24D0041382Sanford Bemidji Medical Center
1300 Anne Street NW, Attn Laboratory, Route 10065, Bemidji, MN 56601		AccreditationMar 8, 2028
24D2121853Sanford Bemidji Medical Center
1300 Anne Street NW, Bemidji, MN 56601		Certificate of waiverNov 14, 2026

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MN

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20140103000371 MN Part B Supplier - Independent Clinical Laboratory 5597725168 Practice locations: Bemidji, MN

National Provider Directory

Tax ID family
North Country Health SE (23 organizations share this tax ID)

Locations

1611 Anne St NW
Bemidji, MN 56601
Phone (218) 333-2020

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Yes

Addresses

Primary practice location

1300 Anne St NW
Bemidji, MN 56601-5103

Mailing address

PO Box 5056
Sioux Falls, SD 57117-5056
Phone (605) 328-5485

Other names

  • Sanford Laboratories Doing business as

Electronic endpoints

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other

Other providers in Bemidji, MN

All providers in Bemidji, MN · Clinical Medical Laboratory in Minnesota

Sources for this page

Verify at the official NPI Registry.