Healther Providers Data Logo

43D1068722 CLIA NUMBER - SIOUXLAND ORAL AND MAXILLOFACIAL SURGERY ASSOCIATES

Laboratory Demographics

CLIA Number: 43D1068722

Facility Name: SIOUXLAND ORAL AND MAXILLOFACIAL SURGERY ASSOCIATES

Facility Address:
6401 S MINNESOTA AVENUE
SIOUX FALLS, SD
ZIP 57108
Get Directions

Facility Phone Number: 605 335-1080

Facility Type: Practitioner Other

Certificate Type: Waiver
NPI Number: 1790757011

Taxonomy: 1223S0112X - Dentist
An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.

CLIA Record

Field Name Field Value
CLIA Number 43D1068722
LAB Type Practitioner Other
Facility Name SIOUXLAND ORAL AND MAXILLOFACIAL SURGERY ASSOCIATES
Street 6401 S MINNESOTA AVENUE
City SIOUX FALLS
State SD
ZIP 57108
Phone 605 335-1080
CertificateType 4
CertificateEffectiveDate 9/16/2022
CertificateExpirationDate 9/15/2024
FacilityType Waiver

Download Record

Download this CLIA NUMBER record in Text format: Export

Download this CLIA NUMBER record in Excel (CSV) format: Export

Download this CLIA NUMBER record in XML format: Export

This page was last updated on: 4/23/2024