Phlebotomist Salary in North Dakota
North Dakota pays a BLS mean of $47,990 per year ($23.07 per hour) for phlebotomy, roughly 5 percent above the national mean of $45,520. On the raw number that is a solid, above-average wage. What sets North Dakota apart is what happens after you account for the cost of living and taxes: prices run about 11 percent below the national average, and a typical single phlebotomist's wage sits entirely in the state's 0-percent income-tax bracket. Put those together and North Dakota tops every other state in the country for real, spendable pay.
Why North Dakota ranks #1 for real pay
Nominal wage rankings put North Dakota in the upper-middle of the pack: its $47,990 state mean sits above the national average but well behind headline leaders like California ($56,600) and Massachusetts ($52,540). The picture flips once cost of living enters. Dividing the state mean by North Dakota's BEA Regional Price Parity of 89.0 (all items, 2024, prices 11 percent below the national level) gives about $53,921 in national-average purchasing power. That is the highest cost-of-living-adjusted phlebotomist wage of any state, edging out California, whose $56,600 nominal wage falls to roughly $51,129 once its 10.7-percent-above-average prices are netted out.
In plain terms, the same phlebotomy paycheck buys more housing, groceries and transportation in Fargo or Bismarck than a larger headline wage does in San Jose or Boston. North Dakota is the clearest example of the general rule that shows up across the state data: a moderately above-average nominal wage combined with a low cost of living beats a high nominal wage in an expensive state.
The full North Dakota pay ladder
The state mean hides a real spread. An entry-level phlebotomist near the 10th percentile earns about $33,840, while an experienced worker at the 90th percentile reaches roughly $58,290, a gap of about $24,000. The percentile ladder below shows where a given wage falls within the North Dakota workforce.
| Percentile | Hourly | Annual |
|---|---|---|
| 10th percentile | $16.27 | $33,840 |
| 25th percentile | $20.08 | $41,770 |
| Median (50th) | $22.81 | $47,430 |
| 75th percentile | $25.83 | $53,730 |
| 90th percentile | $28.02 | $58,290 |
Source: BLS Occupational Employment and Wage Statistics, May 2025 (SOC 31-9097), North Dakota state estimates, cross-industry. State mean $47,990 ($23.07/hr); state median $47,430 ($22.81/hr). BLS does not publish separate metro-area wage estimates for phlebotomists in North Dakota.
Take-home math: a 0-percent income-tax bracket
North Dakota has one of the lowest income-tax burdens in the country for a phlebotomist, and for most it is zero. The state's 2025 individual income tax has just three brackets for a single filer: the first $48,475 of taxable income is taxed at 0 percent, income from $48,475 to $244,825 at 1.95 percent, and income above that at 2.50 percent.
Because North Dakota taxable income starts from your federal taxable income, a single phlebotomist earning the $47,990 state mean is inside the 0-percent band even before subtracting the federal standard deduction, which lowers taxable income further. The result is no North Dakota income tax on a typical phlebotomist's wage. Even a high earner at the 90th percentile ($58,290) would pay only 1.95 percent on the slice of income above $48,475, an income tax bill under $200. These figures are a labeled model based on published 2025 rates, not a tax filing; your own liability depends on your deductions and credits.
Netting it out, North Dakota gives a phlebotomist an above-average nominal wage, the lowest cost of living of any above-average-wage state, and effectively no state income tax. That combination, rather than a headline-topping salary, is what makes it the strongest state in the country for real, spendable phlebotomy pay.
Major North Dakota employers
Fargo corridor. Sanford Health and Essentia Health are the two dominant systems in and around Fargo, the state's largest labor market. Both run hospitals, outpatient clinics and reference laboratories, and together they account for a large share of phlebotomy hiring in the state across inpatient, outpatient and lab-draw settings.
Bismarck, Grand Forks and Minot. CHI St. Alexius Health and Sanford anchor the Bismarck market, Altru Health System anchors Grand Forks, and Trinity Health anchors Minot. These regional systems are the primary employers outside Fargo and hire steadily across hospital and clinic settings.
Reference labs and donor centers. Labcorp and hospital-run laboratories operate patient-draw stations across the state, and blood-donor collection operations such as Vitalant hire donor-collection phlebotomists. Because the North Dakota workforce is small and concentrated in the major health systems, openings are steady but limited in number compared with larger states.
Licensure and credentials
North Dakota does not require a state phlebotomy license or state certification. Unlike California, Washington, Nevada and Louisiana, which regulate the role at the state level, North Dakota lets employers set their own credential requirements. In practice, the large systems prefer or require a national certification for hospital and reference-lab work.
The accepted national credentials are ASCP PBT (American Society for Clinical Pathology), NHA CPT (National Healthcareer Association), AMT RPT (American Medical Technologists), and NCCT NCPT (National Center for Competency Testing). Sanford Health, Essentia Health and Altru tend to prefer a national certification for hospital blood-draw and lab roles, while clinics and donor centers accept any of the major credentials and often train and certify from zero.
Frequently asked questions
How much do phlebotomists make in North Dakota?
North Dakota reports a BLS OEWS May 2025 state mean of $47,990 per year ($23.07 per hour), about 5 percent above the national mean of $45,520. The state median is $47,430 ($22.81 per hour), and the middle half of North Dakota phlebotomists earn between roughly $41,770 and $53,730. North Dakota employed about 220 phlebotomists in May 2025, one of the smallest state workforces in the country, so BLS does not publish separate metro wage estimates for the state.
Does North Dakota have the best phlebotomist pay after cost of living?
Yes. Once each state's mean wage is deflated by its BEA Regional Price Parity (all items, 2024), North Dakota leads the country. Its $47,990 nominal mean is worth about $53,921 in national-average purchasing power because North Dakota's cost of living runs 11 percent below the national average (RPP 89.0). That edges out California, whose higher $56,600 nominal wage falls to about $51,129 adjusted once its 10.7-percent-above-average prices are netted out. Low-cost states with above-average nominal pay, like North Dakota, are where a phlebotomist's paycheck stretches furthest.
How much state income tax does a North Dakota phlebotomist pay?
Effectively none. Under North Dakota's 2025 individual income tax schedule, the first $48,475 of taxable income for a single filer is taxed at 0 percent; only income between $48,475 and $244,825 is taxed at 1.95 percent, and income above that at 2.50 percent. Because North Dakota taxable income starts from federal taxable income, a single phlebotomist earning the $47,990 state mean is comfortably inside the 0-percent band even before the federal standard deduction, so they owe no North Dakota income tax. That is a genuine take-home advantage over most states, and it stacks on top of the low cost of living. This is a labeled model based on published rates, not a tax filing.
Does North Dakota require a phlebotomy license?
No. North Dakota does not require a state-level phlebotomy license or state certification to draw blood, unlike California, Washington, Nevada and Louisiana, which regulate the role at the state level. National credentials (ASCP PBT, NHA CPT, AMT RPT, NCCT NCPT) are accepted or preferred at nearly all North Dakota employers. The large regional systems such as Sanford Health and Essentia Health typically prefer or require a national certification for hospital and reference-lab work, while clinics and donor centers often train from zero.
Who are the largest phlebotomy employers in North Dakota?
Sanford Health and Essentia Health are the two dominant systems in the Fargo market, each running hospitals, clinics and reference laboratories that employ phlebotomists across inpatient, outpatient and lab settings. Altru Health System anchors Grand Forks, CHI St. Alexius Health and Sanford anchor Bismarck, and Trinity Health anchors Minot. Reference-lab and donor employers include Labcorp and hospital-run laboratories, plus Vitalant and other blood-donor collection operations. Because the state workforce is small and concentrated in these systems, openings are steady but limited in number.