43D0719165 CLIA NUMBER - AVERA MEDICAL GROUP HEALTH CARE CLINIC

Laboratory Demographics

  • CLIA Code: 43D0719165
  • Facility Name: AVERA MEDICAL GROUP HEALTH CARE CLINIC
  • Facility Address: 300 NORTH DAKOTA AVENUE SUITE 117
    SIOUX FALLS, SD
    ZIP 57104
  • Facility Phone: 605 322-6827
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: JOHN SRSTKA
  • NPI Number: 1083894067
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 43D0719165
LAB Type Community Clinic
Facility Name AVERA MEDICAL GROUP HEALTH CARE CLINIC
Street 300 NORTH DAKOTA AVENUE SUITE 117
City SIOUX FALLS
State SD
ZIP 57104
Phone 605 322-6827
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/1/2025
Certificate Expiration Date 3/31/2027
Facility Type Community Clinic
Lab Director JOHN SRSTKA

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