43D0406801 CLIA NUMBER - SANFORD CLINIC - CANTON FAMILY PHYSICIANS

Laboratory Demographics

  • CLIA Code: 43D0406801
  • Facility Name: SANFORD CLINIC - CANTON FAMILY PHYSICIANS
  • Facility Address: 400 N HIAWATHA DRIVE
    CANTON, SD
    ZIP 57013
  • Facility Phone: 605 764-1500
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: MICHELLE JOHNSON
  • NPI Number: 1144259052
  • Taxonomy: 207RC0000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 43D0406801
LAB Type Physician Office
Facility Name SANFORD CLINIC - CANTON FAMILY PHYSICIANS
Street 400 N HIAWATHA DRIVE
City CANTON
State SD
ZIP 57013
Phone 605 764-1500
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 1/27/2024
Certificate Expiration Date 1/26/2026
Facility Type Physician Office
Lab Director MICHELLE JOHNSON

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