43D1051254 CLIA NUMBER - LAKE NORDEN AMBULANCE DISTRICT

Laboratory Demographics

  • CLIA Code: 43D1051254
  • Facility Name: LAKE NORDEN AMBULANCE DISTRICT
  • Facility Address: 600 MAIN AVENUE PO BOX 71
    LAKE NORDEN, SD
    ZIP 57248
  • Facility Phone: 605 785-2114
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: JENNIFER HAOLLSTROM
  • NPI Number: 1538725841
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 43D1051254
LAB Type Ambulance
Facility Name LAKE NORDEN AMBULANCE DISTRICT
Street 600 MAIN AVENUE PO BOX 71
City LAKE NORDEN
State SD
ZIP 57248
Phone 605 785-2114
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/27/2024
Certificate Expiration Date 2/26/2026
Facility Type Ambulance
Lab Director JENNIFER HAOLLSTROM

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