43D1079733 CLIA NUMBER - MED-STAR PARAMEDIC, INC

Laboratory Demographics

  • CLIA Code: 43D1079733
  • Facility Name: MED-STAR PARAMEDIC, INC
  • Facility Address: 922 E REDWOOD AVENUE
    BRANDON, SD
    ZIP 57005
  • Facility Phone: 605 582-6096
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: JACK MASUR
  • NPI Number: 1720528110
  • Taxonomy: 343900000X - Non-emergency Medical Transport (VAN)

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CLIA Record

Field Name Field Value
CLIA Number 43D1079733
LAB Type Ambulance
Facility Name MED-STAR PARAMEDIC, INC
Street 922 E REDWOOD AVENUE
City BRANDON
State SD
ZIP 57005
Phone 605 582-6096
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/6/2024
Certificate Expiration Date 2/5/2026
Facility Type Ambulance
Lab Director JACK MASUR

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