ALTRU FAMILY MEDICINE CENTER
NPI 1174662852
Non-Pharmacy Dispensing Site in Grand Forks, ND

Q: What is Altru Family Medicine Center's NPI number?

The NPI number for Altru Family Medicine Center is 1174662852. It was assigned to this organization in the NPPES registry on February 6, 2007.

Q: What is Altru Family Medicine Center's specialty?

The primary specialty registered for this NPI is Non-Pharmacy Dispensing Site with taxonomy code 332900000X.

Active since February 06, 2007CLIA 35D2320606 · Waiver

1380 S COLUMBIA RD, GRAND FORKS, ND 58201(701) 795-2230 Get Directions Write a Review

NPPES record last updated: October 16, 2012. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Altru Family Medicine Center NPPES

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

ALTRU FAMILY MEDICINE CENTER (NPI 1174662852) is a healthcare organization registered as a non-pharmacy dispensing site in Grand Forks, North Dakota and active in the NPI registry since February 2007. The organization holds a CLIA Waiver certificate valid through March 19, 2027 and lists Kenny Heine, Director Of Operations, as its authorized official.

NPPES Registry Identity

NPI1174662852

Entity TypeOrganization

Primary Taxonomy332900000X

Legal Business NameALTRU FAMILY MEDICINE CENTER

Location Address1380 S COLUMBIA RDGrand Forks, ND 58201-4059

Mailing Address5626 Oberlin Dr, Suite 110San Diego, CA 92121-1705 · (858) 625-2990 · Fax (858) 625-2999

Phone(701) 795-2230

Organization SubpartYesParent: Medvantx, Inc.

Authorized OfficialKenny HeineDirector Of Operations · (858) 625-2990

Enumeration DateFebruary 6, 2007

Last NPPES UpdateOctober 16, 2012

✔ NPI 1174662852 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNon-Pharmacy Dispensing SiteSuppliers

Taxonomy Code332900000X

License✔ Licensed in ND · 5809

Definition

A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.)

1380 S COLUMBIA RD, Grand Forks, ND 58201

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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 Waiver 35D2320606

Altru Family Medicine Center · Grand Forks, ND

Active · expires Mar 19, 2027

CLIA Number35D2320606

Laboratory TypeCommunity Clinic

Certificate Effective DateMarch 20, 2025

Certificate Expiration DateMarch 19, 2027

Laboratory DirectorYan Xia

Laboratory Phone(701) 780-5133

Laboratory LocationAltru Family Medicine Center1380 S Columbia Rd, Grand Forks, ND 58201

CLIA data matches this NPI record on: Address Name

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

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

MRS. BETH A ANVARINIA FNP-C

Nurse Practitioner (Family)