43D1049841 CLIA NUMBER - EDGEMONT AMBULANCE SERVICE

Laboratory Demographics

  • CLIA Code: 43D1049841
  • Facility Name: EDGEMONT AMBULANCE SERVICE
  • Facility Address: SECOND AND C STREET PO BOX 725
    EDGEMONT, SD
    ZIP 57735
  • Facility Phone: 605 662-7977
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: BRADLEY PHAR
  • NPI Number: 1104901693
  • Taxonomy: 251300000X - Local Education Agency (LEA)

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CLIA Record

Field Name Field Value
CLIA Number 43D1049841
LAB Type Ambulance
Facility Name EDGEMONT AMBULANCE SERVICE
Street SECOND AND C STREET PO BOX 725
City EDGEMONT
State SD
ZIP 57735
Phone 605 662-7977
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/19/2024
Certificate Expiration Date 1/18/2026
Facility Type Ambulance
Lab Director BRADLEY PHAR

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