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

Laboratory Demographics

  • CLIA Code: 43D0407595
  • Facility Name: AVERA MEDICAL GROUP OBSTETRICS & GYNECOLOGY ABERDEEN
  • Facility Address: 310 S PENN STREET SUITE 204
    ABERDEEN, SD
    ZIP 57401
  • Facility Phone: 605 225-1636
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: TAGE BORN
  • NPI Number: 1881824977
  • Taxonomy: 2084N0400X - Psychiatry & Neurology

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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
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 7/1/2025
Certificate Expiration Date 6/30/2027
Facility Type Physician Office
Lab Director TAGE BORN

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