43D1037546 CLIA NUMBER - AVERA ST BENEDICT CERTIFIED RHC

Laboratory Demographics

  • CLIA Code: 43D1037546
  • Facility Name: AVERA ST BENEDICT CERTIFIED RHC
  • Facility Address: 401 WEST GLYNN DRIVE
    PARKSTON, SD
    ZIP 57366
  • Facility Phone: 605 928-7961
  • Facility Type: Rural Health Clinic
  • Facility Type: Waiver
  • Lab Director: JASON WICKERSHAM
  • NPI Number: 1740355635
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 43D1037546
LAB Type Rural Health Clinic
Facility Name AVERA ST BENEDICT CERTIFIED RHC
Street 401 WEST GLYNN DRIVE
City PARKSTON
State SD
ZIP 57366
Phone 605 928-7961
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/28/2025
Certificate Expiration Date 2/27/2027
Facility Type Rural Health Clinic
Lab Director JASON WICKERSHAM

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