43D1049904 CLIA NUMBER - SELBY VOLUNTEER AMUBLANCE INC

Laboratory Demographics

  • CLIA Code: 43D1049904
  • Facility Name: SELBY VOLUNTEER AMUBLANCE INC
  • Facility Address: 2511 3RD AVENUE PO BOX 192
    SELBY, SD
    ZIP 57472
  • Facility Phone: 605 649-7874
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: LADEAN MOAK
  • NPI Number: 1275687386
  • Taxonomy: 3416L0300X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 43D1049904
LAB Type Ambulance
Facility Name SELBY VOLUNTEER AMUBLANCE INC
Street 2511 3RD AVENUE PO BOX 192
City SELBY
State SD
ZIP 57472
Phone 605 649-7874
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/20/2024
Certificate Expiration Date 1/19/2026
Facility Type Ambulance
Lab Director LADEAN MOAK

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