43D0998669 CLIA NUMBER - BLACK HILLS DIALYSIS SYSTEMS LLC PINE RIDGE

Laboratory Demographics

  • CLIA Code: 43D0998669
  • Facility Name: BLACK HILLS DIALYSIS SYSTEMS LLC PINE RIDGE
  • Facility Address: 100 DIALYSIS DRIVE POST OFFICE BOX 3013
    PINE RIDGE, SD
    ZIP 57770
  • Facility Phone: 605 867-5983
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: BETTY COX
  • NPI Number: 1710087713
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 43D0998669
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name BLACK HILLS DIALYSIS SYSTEMS LLC PINE RIDGE
Street 100 DIALYSIS DRIVE POST OFFICE BOX 3013
City PINE RIDGE
State SD
ZIP 57770
Phone 605 867-5983
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/22/2024
Certificate Expiration Date 4/21/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director BETTY COX

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