43D1071459 CLIA NUMBER - BLACK HILLS LIFE FLIGHT

Laboratory Demographics

CLIA Number: 43D1071459

Facility Name: BLACK HILLS LIFE FLIGHT

Facility Address:
4025 LACROIS COURT
RAPID CITY, SD
ZIP 57703
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Facility Phone Number: 402 290-8705

Facility Type: Ambulance

Certificate Type: Waiver

NPI Number: 1376896621

Taxonomy: 284300000X - Special Hospital
A designation by the AHA of a hospital whose primary function of the institution is to provide diagnostic and treatment services for patients who have specified medical conditions, both surgical and nonsurgical.

CLIA Record

Field Name	Field Value
CLIA Number	43D1071459
LAB Type	Ambulance
Facility Name	BLACK HILLS LIFE FLIGHT
Street	4025 LACROIS COURT
City	RAPID CITY
State	SD
ZIP	57703
Phone	402 290-8705
CertificateType	4
CertificateEffectiveDate	7/1/2022
CertificateExpirationDate	6/30/2024
FacilityType	Waiver

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