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43D0673527 CLIA NUMBER - BONHOMME FAMILY PRACTICE CERTIFIED RURAL HEALTH

Laboratory Demographics

CLIA Number: 43D0673527

Facility Name: BONHOMME FAMILY PRACTICE CERTIFIED RURAL HEALTH

Facility Address:
410 WEST 16TH AVENUE
TYNDALL, SD
ZIP 57066
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Facility Phone Number: 605 589-3322

Facility Type: Rural Health Clinic

Certificate Type: Waiver
NPI Number: 1730329665

Taxonomy: 251300000X - Local Education Agency (LEA)
The term local education agency means a public board of education or other public authority legally constituted within a State to either provide administrative control or direction of, or perform a service function for public schools serving individuals ages 0 - 21 in a state, city, county, township, school district, or other political subdivision including a combination of school districts or counties recognized in a State as an administrative agency for its public schools. An LEA may provide, or employ professional who provide, services to children included in the Individuals with Disabilities Education Act (IDEA), such services may include, but are not limited to, such medical services as physical, occupational, and speech therapy.

CLIA Record

Field Name Field Value
CLIA Number 43D0673527
LAB Type Rural Health Clinic
Facility Name BONHOMME FAMILY PRACTICE CERTIFIED RURAL HEALTH
Street 410 WEST 16TH AVENUE
City TYNDALL
State SD
ZIP 57066
Phone 605 589-3322
CertificateType 4
CertificateEffectiveDate 9/1/2022
CertificateExpirationDate 8/31/2024
FacilityType Waiver

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