LAKE SUPERIOR COMMUNITY HEALTH CENTER
NPI 1568832277
Clinic/Center - Federally Qualified Health Center (FQHC) in Duluth, MN

Q: 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.

Active since October 07, 2015CLIA 24D0403966 · Accreditation

4325 GRAND AVE, DULUTH, MN 55807(218) 722-1497(218) 727-8346 Get Directions Write a Review

NPPES record last updated: August 26, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

On this page

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 1568832277) is a healthcare organization registered as a federally qualified health center (fqhc) in Duluth, Minnesota and active in the NPI registry since October 2015. The organization holds an CLIA Accreditation certificate valid through January 15, 2027 and lists Katrina Jaworski, Director Of Finance, as its authorized official.

NPPES Registry Identity

NPI1568832277

Entity TypeOrganization

Primary Taxonomy261QF0400X

Legal Business NameLAKE SUPERIOR COMMUNITY HEALTH CENTER

Location Address4325 GRAND AVEDuluth, MN 55807-2730

Mailing Address3600 Tower AveSuperior, WI 54880-5589 · (715) 392-1955

Phone(218) 722-1497

Fax(218) 727-8346

Organization SubpartNo

Authorized OfficialKatrina JaworskiDirector Of Finance · (715) 392-1955

Enumeration DateOctober 7, 2015

Last NPPES UpdateAugust 26, 2020

NPPES CertifiedAugust 26, 2020

✔ NPI 1568832277 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities

Taxonomy Code261QF0400X

Also ListedClinic/Center · Primary CareTaxonomy 261QP2300X · License R 228856-1 (MN)

4325 GRAND AVE, Duluth, MN 55807

Open in Google Maps ↗

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 24D0403966

Lake Superior Community Health Center · Duluth, MN

Active · expires Jan 15, 2027

CLIA Number24D0403966

Laboratory TypeFederally Qualified Health Center

Certificate Effective DateJanuary 16, 2025

Certificate Expiration DateJanuary 15, 2027

Laboratory DirectorColleen Hill

Laboratory Phone(218) 722-1497

Laboratory LocationLake Superior Community Health Center4325 Grand Avenue Suite 1, Duluth, MN 55807

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.

Leave this field empty

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.

MADHURI BASAK RNC

Registered Nurse (Ambulatory Care)