RAINY LAKE CLINIC - LITTLEFORK
NPI 1912365529
Non-Pharmacy Dispensing Site in Littlefork, MN

Q: What is International Falls Memorial Hospital Association's specialty?

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

Active since February 10, 2016CLIA 24D0041406 · Waiver

912 MAIN ST, LITTLEFORK, MN 56653(218) 283-7872 Get Directions Write a Review

NPPES record last updated: June 2, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jun 2, 2021, Feb 10, 2016 (2 updates tracked since 2016).

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About Rainy Lake Clinic - Littlefork NPPES

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

RAINY LAKE CLINIC - LITTLEFORK (NPI 1912365529) is a healthcare organization registered as a non-pharmacy dispensing site in Littlefork, Minnesota and active in the NPI registry since February 2016. The organization holds a CLIA Waiver certificate valid through January 31, 2028 and lists Robert Pastor, Ceo, as its authorized official.

NPPES Registry Identity

NPI1912365529

Entity TypeOrganization

Primary Taxonomy332900000X

Legal Business NameINTERNATIONAL FALLS MEMORIAL HOSPITAL ASSOCIATION

Location Address912 MAIN STLittlefork, MN 56653-9357

Mailing Address6501 City West PkwyEden Prairie, MN 55344-3248 · (952) 653-2525

Phone(218) 283-7872

Organization SubpartYes

Authorized OfficialRobert PastorCeo · (218) 283-5488

Enumeration DateFebruary 10, 2016

Last NPPES UpdateJune 2, 20212 updates tracked since enumeration

NPPES CertifiedJune 2, 2021

✔ NPI 1912365529 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNon-Pharmacy Dispensing SiteSuppliers

Taxonomy Code332900000X

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.)

912 MAIN ST, Littlefork, MN 56653

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Other Names 1

Doing Business AsRainy Lake Clinic - Littlefork

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Antidote Health Plan of Arizona, Inc., Antidote Health Plan of Ohio, Inc. and more.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 24D0041406

Rainy Lake Clinic-Littlefork · Littlefork, MN

Active · expires Jan 31, 2028

CLIA Number24D0041406

Laboratory TypeRural Health Clinic

Certificate Effective DateFebruary 1, 2026

Certificate Expiration DateJanuary 31, 2028

Laboratory DirectorKim Usery

Laboratory Phone(218) 278-6634

Laboratory LocationRainy Lake Clinic-Littlefork912 Main Street, Littlefork, MN 56653

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.

KOOCHICHING HEALTH SERVICES

Assisted Living Facility