24D0405330 CLIA NUMBER - AVERA MEDICAL GROUP TYLER

Laboratory Demographics

  • CLIA Code: 24D0405330
  • Facility Name: AVERA MEDICAL GROUP TYLER
  • Facility Address: 240 WILLOW STREET
    TYLER, MN
    ZIP 56178
  • Facility Phone: 507 247-5521
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DEENA L. AUS
  • NPI Number: 1962859058
  • Taxonomy: 122300000X - Dentist

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CLIA Record

Field Name Field Value
CLIA Number 24D0405330
LAB Type Physician Office
Facility Name AVERA MEDICAL GROUP TYLER
Street 240 WILLOW STREET
City TYLER
State MN
ZIP 56178
Phone 507 247-5521
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/1/2024
Certificate Expiration Date 3/31/2026
Facility Type Physician Office
Lab Director DEENA L. AUS

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This page was last updated on: 9/29/2025