43D0407595 CLIA NUMBER - AVERA MEDICAL GROUP OBSTETRICS & GYNECOLOGY ABERDEEN

Laboratory Demographics

CLIA Number: 43D0407595

Facility Name: AVERA MEDICAL GROUP OBSTETRICS & GYNECOLOGY ABERDEEN

Facility Address:
310 S PENN STREET SUITE 204
ABERDEEN, SD
ZIP 57401
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Facility Phone Number: 605 225-1636

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1881824977

Taxonomy: 2084N0400X - Psychiatry & Neurology
A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.

CLIA Record

Field Name	Field Value
CLIA Number	43D0407595
LAB Type	Physician Office
Facility Name	AVERA MEDICAL GROUP OBSTETRICS & GYNECOLOGY ABERDEEN
Street	310 S PENN STREET SUITE 204
City	ABERDEEN
State	SD
ZIP	57401
Phone	605 225-1636
CertificateType	3
CertificateEffectiveDate	7/1/2023
CertificateExpirationDate	6/30/2025
FacilityType	PPMP

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