43D1054703 CLIA NUMBER - AVERA MEDICAL GROUP BIG STONE CITY CLINIC

Laboratory Demographics

  • CLIA Code: 43D1054703
  • Facility Name: AVERA MEDICAL GROUP BIG STONE CITY CLINIC
  • Facility Address: 451 MAIN STREET
    BIG STONE CITY, SD
    ZIP 57216
  • Facility Phone: 605 862-7999
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: PATRICK DREIS
  • NPI Number: 1497847446
  • Taxonomy: 363A00000X - Physician Assistant

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CLIA Record

Field Name Field Value
CLIA Number 43D1054703
LAB Type Community Clinic
Facility Name AVERA MEDICAL GROUP BIG STONE CITY CLINIC
Street 451 MAIN STREET
City BIG STONE CITY
State SD
ZIP 57216
Phone 605 862-7999
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/15/2025
Certificate Expiration Date 1/14/2027
Facility Type Community Clinic
Lab Director PATRICK DREIS

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