AVERA MEDICAL GROUP CARLSON
NPI 1407330301
Clinic/Center - Multi-Specialty in Marshall, MN

Q: What is Avera Marshall's NPI number?

The NPI number for Avera Marshall is 1407330301. It was assigned to this organization in the NPPES registry on September 18, 2018.

Q: What is Avera Marshall's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Avera Marshall was last updated on December 2, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since September 18, 2018CLIA 24D2159579 · Waiver

1521 CARLSON ST, MARSHALL, MN 56258(507) 532-9631 Get Directions Write a Review

NPPES record last updated: December 2, 2022. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Dec 2, 2022, Sep 18, 2018 (2 updates tracked since 2018).

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About Avera Medical Group Carlson NPPES

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

AVERA MEDICAL GROUP CARLSON (NPI 1407330301) is a healthcare organization registered as a multi-specialty in Marshall, Minnesota and active in the NPI registry since September 2018. The organization holds a CLIA Waiver certificate valid through December 19, 2026 and lists Debbie Streier, Ceo, as its authorized official.

NPPES Registry Identity

NPI1407330301

Entity TypeOrganization

Primary Taxonomy261QM1300X

Legal Business NameAVERA MARSHALL

Location Address1521 CARLSON STMarshall, MN 56258-2626

Mailing Address1521 Carlson StMarshall, MN 56258-2626

Phone(507) 532-9631

Organization SubpartNo

Authorized OfficialDebbie StreierCeo · (507) 537-9160

Enumeration DateSeptember 18, 2018

Last NPPES UpdateDecember 2, 20222 updates tracked since enumeration

NPPES CertifiedDecember 2, 2022

✔ NPI 1407330301 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Multi-SpecialtyAmbulatory Health Care Facilities

Taxonomy Code261QM1300X

1521 CARLSON ST, Marshall, MN 56258

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Other Names 1

Doing Business AsAvera Medical Group Carlson

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 24D2159579

Avera Medical Group Carlson (coag Clinic) · Marshall, MN

Active · expires Dec 19, 2026

CLIA Number24D2159579

Laboratory TypeCoumadin Clinic

Certificate Effective DateDecember 20, 2024

Certificate Expiration DateDecember 19, 2026

Laboratory DirectorSteven Meister

Laboratory Phone(507) 476-4800

Laboratory LocationAvera Medical Group Carlson (coag Clinic)1521 Carlson Street, Marshall, MN 56258

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 14

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

DR. VINCENT D LAPORTE MD

Family Medicine