ESSENTIA HEALTH LAKESIDE CLINIC
NPI 1245278936
Clinic/Center - Multi-Specialty in Duluth, MN

Active since June 03, 2006CLIA 24D0403946 · Waiver
4621 E SUPERIOR ST, DULUTH, MN 55804(218) 786-3550 Get Directions Write a Review

NPPES record last updated: February 28, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Essentia Health Lakeside Clinic NPPES

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

ESSENTIA HEALTH LAKESIDE CLINIC (NPI 1245278936) is a healthcare organization registered as a multi-specialty in Duluth, Minnesota and active in the NPI registry since June 2006. The organization holds a CLIA Waiver certificate valid through September 30, 2027 and lists Kevin Boren, Vp Of Finance, as its authorized official.

NPPES Registry Identity

NPI1245278936
Entity TypeOrganization
Primary Taxonomy261QM1300X
Legal Business NameTHE DULUTH CLINIC, LTD
Location Address4621 E SUPERIOR STDuluth, MN 55804-2338
Mailing Address4621 E Superior StDuluth, MN 55804-2338 · (218) 786-3550
Organization SubpartYesParent: Essentia Health
Authorized OfficialKevin BorenVp Of Finance · (218) 786-1009
Enumeration DateJune 3, 2006
Last NPPES UpdateFebruary 28, 2024
NPPES CertifiedFebruary 28, 2024
NPI 1245278936 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyClinic/Center · Multi-SpecialtyAmbulatory Health Care Facilities
Taxonomy Code261QM1300X
Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X
4621 E SUPERIOR ST, Duluth, MN 55804

Other Names 1

Doing Business AsEssentia Health Lakeside Clinic

Other Identifiers 1

Medicaid1245278936MN

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 Waiver 24D0403946

Essentia Health Lakeside Clinic · Duluth, MN
Active · expires Sep 30, 2027
CLIA Number24D0403946
Laboratory TypePhysician Office
Certificate Effective DateOctober 1, 2025
Certificate Expiration DateSeptember 30, 2027
Laboratory DirectorSandra Mattson
Laboratory Phone(218) 576-0448
Laboratory LocationEssentia Health Lakeside Clinic4621 East Superior Street, Duluth, MN 55804
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.

Family Medicine
4621 E SUPERIOR ST
DULUTH, MN 55804
Physical Therapist
4621 E SUPERIOR ST
DULUTH, MN 55804
Physical Therapist
4621 E SUPERIOR ST
DULUTH, MN 55804
Physical Therapist
4621 E SUPERIOR ST
DULUTH, MN 55804
Family Medicine
4621 E SUPERIOR ST
DULUTH, MN 55804
Physical Therapist
4621 E SUPERIOR ST
DULUTH, MN 55804
Physical Therapist
4621 E SUPERIOR ST
DULUTH, MN 55804
Physical Therapist
4621 E SUPERIOR ST
DULUTH, MN 55804

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 The Duluth Clinic, Ltd's NPI number?

The NPI number for The Duluth Clinic, Ltd is 1245278936. It was assigned to this organization in the NPPES registry on June 3, 2006. The provider is doing business as Essentia Health Lakeside Clinic.

Where is The Duluth Clinic, Ltd located?

The Duluth Clinic, Ltd is located at 4621 E Superior St, Duluth, MN 55804. The listed phone number is (218) 786-3550.

What is The Duluth Clinic, Ltd's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.

Does The Duluth Clinic, Ltd hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 24D0403946) is associated with this NPI, valid through September 30, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does The Duluth Clinic, Ltd accept?

Health plans from HealthPartners, Medica, Sanford Health Plan and Security Health Plan list The Duluth Clinic, Ltd 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 The Duluth Clinic, Ltd was last updated on February 28, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.