LAKE SUPERIOR COMMUNITY HEALTH CENTER
NPI 1013556638
Clinic/Center - Federally Qualified Health Center (FQHC) in Duluth, MN

Active since December 30, 2019CLIA 52D2249300 · Accreditation
4602 GRAND AVE STE 1000, DULUTH, MN 55807(218) 336-3520(218) 624-6097 Get Directions Write a Review

NPPES record last updated: February 13, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Nov 10, 2023, Feb 3, 2022, Oct 15, 2021 and 4 more (7 updates tracked since 2019).

About Lake Superior Community Health Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LAKE SUPERIOR COMMUNITY HEALTH CENTER (NPI 1013556638) is a healthcare organization registered as a federally qualified health center (fqhc) in Duluth, Minnesota and active in the NPI registry since December 2019. The organization holds an CLIA Accreditation certificate valid through January 9, 2027 and lists Lee Homan, Ceo, as its authorized official.

NPPES Registry Identity

NPI1013556638
Entity TypeOrganization
Primary Taxonomy261QF0400X
Legal Business NameLAKE SUPERIOR COMMUNITY HEALTH CENTER
Location Address4602 GRAND AVE STE 1000Duluth, MN 55807-2712
Mailing Address2222 E 5th StSuperior, WI 54880-3709 · (715) 392-1955 · Fax (715) 392-1935
Fax(218) 624-6097
Organization SubpartNo
Authorized OfficialLee HomanCeo · (715) 392-1955
Enumeration DateDecember 30, 2019
Last NPPES UpdateFebruary 13, 20247 updates tracked since enumeration
NPPES CertifiedFebruary 13, 2024
NPI 1013556638 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinic/Center · Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
Taxonomy Code261QF0400X
4602 GRAND AVE STE 1000, Duluth, MN 55807

Accepted Insurance

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Accreditation 52D2249300

Lake Superior Community Health Center - Superior · Superior, WI
Active · expires Jan 9, 2027
CLIA Number52D2249300
Laboratory TypeFederally Qualified Health Center
Certificate Effective DateJanuary 10, 2025
Certificate Expiration DateJanuary 9, 2027
Laboratory DirectorColleen Hill
Laboratory Phone(715) 392-1955
Laboratory LocationLake Superior Community Health Center - Superior2222 E 5th St, Superior, WI 54880
CLIA data matches this NPI record on: Address Name Phone
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Chiropractor
4602 GRAND AVE STE 1000
DULUTH, MN 55807
Chiropractor
4602 GRAND AVE STE 1000
DULUTH, MN 55807

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lake Superior Community Health Center's NPI number?

The NPI number for Lake Superior Community Health Center is 1013556638. It was assigned to this organization in the NPPES registry on December 30, 2019.

Where is Lake Superior Community Health Center located?

Lake Superior Community Health Center is located at 4602 Grand Ave Ste 1000, Duluth, MN 55807. The listed phone number is (218) 336-3520.

What is Lake Superior Community Health Center's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.

Does Lake Superior Community Health Center hold a CLIA laboratory certificate?

Yes. A Certificate of Accreditation (number 52D2249300) is associated with this NPI, valid through January 9, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Lake Superior Community Health Center accept?

Health plans from HealthPartners list Lake Superior Community Health Center as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Lake Superior Community Health Center was last updated on February 13, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.