43D0663436 CLIA NUMBER - MONUMENT HEALTH CUSTER CLINIC

Laboratory Demographics

  • CLIA Code: 43D0663436
  • Facility Name: MONUMENT HEALTH CUSTER CLINIC
  • Facility Address: 1220 MONTGOMERY ST
    CUSTER, SD
    ZIP 57730
  • Facility Phone: 605 673-9460
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: LISA M. BROWN
  • NPI Number: 1386640126
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 43D0663436
LAB Type Physician Office
Facility Name MONUMENT HEALTH CUSTER CLINIC
Street 1220 MONTGOMERY ST
City CUSTER
State SD
ZIP 57730
Phone 605 673-9460
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/30/2024
Certificate Expiration Date 6/29/2026
Facility Type Physician Office
Lab Director LISA M. BROWN

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