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SANFORD BEMIDJI CASS LAKE CLINIC
NPI 1790710853
Family Medicine in Cass Lake, MN

Active since July 11, 2006CLIA 24D0406580 · Waiver
219 GRANT UTLEY AVENUE NW, CASS LAKE, MN 56633(218) 335-2559(218) 335-2755 Get Directions Write a Review

NPPES record last updated: November 2, 2011. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Sanford Bemidji Cass Lake Clinic NPPES

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

SANFORD BEMIDJI CASS LAKE CLINIC (NPI 1790710853) is a healthcare organization registered as a family medicine in Cass Lake, Minnesota and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through August 31, 2027 and lists Martha K Leclerc, Vp, as its authorized official.

NPPES Registry Identity

NPI1790710853
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameSANFORD CLINIC NORTH
Location Address219 GRANT UTLEY AVENUE NWCass Lake, MN 56633-0067
Mailing Address720 4th St N, Po Box 2010Fargo, ND 58122-0605 · (218) 335-2559 · Fax (218) 335-2755
Phone(218) 335-2559
Fax(218) 335-2755
Organization SubpartNo
Authorized OfficialMartha K LeclercVp · (701) 234-6248
Enumeration DateJuly 11, 2006
Last NPPES UpdateNovember 2, 2011
✔ NPI 1790710853 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
219 GRANT UTLEY AVENUE NW, Cass Lake, MN 56633
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Other Names 1

Doing Business AsSanford Bemidji Cass Lake Clinic

Other Identifiers 2

Medicare OSCAR/certification243816MN
Medicaid961888100MN

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

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 24D0406580

Sanford Bemidji Cass Lake Clinic · Cass Lake, MN
Active · expires Aug 31, 2027
CLIA Number24D0406580
Laboratory TypeCommunity Clinic
Certificate Effective DateSeptember 1, 2025
Certificate Expiration DateAugust 31, 2027
Laboratory DirectorMari K. Osborne
Laboratory Phone(218) 335-2559
Laboratory LocationSanford Bemidji Cass Lake Clinic219 Grant Utley Avenue, Cass Lake, MN 56633
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Sanford Clinic North's NPI number?

The NPI number for Sanford Clinic North is 1790710853. It was assigned to this organization in the NPPES registry on July 11, 2006. The provider is doing business as Sanford Bemidji Cass Lake Clinic.

Where is Sanford Clinic North located?

Sanford Clinic North is located at 219 Grant Utley Avenue NW, Cass Lake, MN 56633. The listed phone number is (218) 335-2559.

What is Sanford Clinic North's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Sanford Clinic North hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 24D0406580) is associated with this NPI, valid through August 31, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Sanford Clinic North was last updated on November 2, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.