43D0933780 CLIA NUMBER - PINE RIDGE SERVICE UNIT WOMENS HEALTH CLINIC

Laboratory Demographics

  • CLIA Code: 43D0933780
  • Facility Name: PINE RIDGE SERVICE UNIT WOMENS HEALTH CLINIC
  • Facility Address: 607 INDIAN HEALTH ROAD EAST HYW 18
    PINE RIDGE, SD
    ZIP 57770
  • Facility Phone: 605 867-3128
  • Facility Type: Other
  • Facility Type: Microscopy
  • Lab Director: CANDACE NORWOOD WILSON
  • NPI Number: 1356663256
  • Taxonomy: 282N00000X - General Acute Care Hospital

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CLIA Record

Field Name Field Value
CLIA Number 43D0933780
LAB Type Other
Facility Name PINE RIDGE SERVICE UNIT WOMENS HEALTH CLINIC
Street 607 INDIAN HEALTH ROAD EAST HYW 18
City PINE RIDGE
State SD
ZIP 57770
Phone 605 867-3128
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 4/8/2025
Certificate Expiration Date 4/7/2027
Facility Type Other
Lab Director CANDACE NORWOOD WILSON

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