43D1058328 CLIA NUMBER - SHANE'S PHARMACY

Laboratory Demographics

  • CLIA Code: 43D1058328
  • Facility Name: SHANE'S PHARMACY
  • Facility Address: 213 EAST HUSTAN AVE
    FORT PIERRE, SD
    ZIP 57532
  • Facility Phone: 605 609-7873
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BRANDY J. LUDEMANN
  • NPI Number: 1720732589
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 43D1058328
LAB Type Pharmacy
Facility Name SHANE'S PHARMACY
Street 213 EAST HUSTAN AVE
City FORT PIERRE
State SD
ZIP 57532
Phone 605 609-7873
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/5/2024
Certificate Expiration Date 9/4/2026
Facility Type Pharmacy
Lab Director BRANDY J. LUDEMANN

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