43D0406778 CLIA NUMBER - AVERA MEDICAL GRP-DEPT OF BROOKINGS HEALTH SYSTEM

Laboratory Demographics

CLIA Number: 43D0406778

Facility Name: AVERA MEDICAL GRP-DEPT OF BROOKINGS HEALTH SYSTEM

Facility Address:
400 22ND AVENUE
BROOKINGS, SD
ZIP 57006
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Facility Phone Number: 605 692-9530

Facility Type: Physician Office

Certificate Type: Accreditation

NPI Number: 1982057246

Taxonomy: 261QM1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	43D0406778
LAB Type	Physician Office
Facility Name	AVERA MEDICAL GRP-DEPT OF BROOKINGS HEALTH SYSTEM
Street	400 22ND AVENUE
City	BROOKINGS
State	SD
ZIP	57006
Phone	605 692-9530
CertificateType	1
CertificateEffectiveDate	6/22/2022
CertificateExpirationDate	6/21/2024
FacilityType	Accreditation

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This page was last updated on: 4/23/2024