43D0406845 CLIA NUMBER - AVERA MEDICAL GROUP GARRETSON

Laboratory Demographics

  • CLIA Code: 43D0406845
  • Facility Name: AVERA MEDICAL GROUP GARRETSON
  • Facility Address: 980 4TH STREET PO BOX 250
    GARRETSON, SD
    ZIP 57030
  • Facility Phone: 605 594-3431
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: BRETT VERCRUYSSE
  • NPI Number: 1174671242
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 43D0406845
LAB Type Community Clinic
Facility Name AVERA MEDICAL GROUP GARRETSON
Street 980 4TH STREET PO BOX 250
City GARRETSON
State SD
ZIP 57030
Phone 605 594-3431
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/2/2024
Certificate Expiration Date 8/1/2026
Facility Type Community Clinic
Lab Director BRETT VERCRUYSSE

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