43D2047251 CLIA NUMBER - SANFORD CLINIC FAMILY MEDICINE BRANDON

Laboratory Demographics

  • CLIA Code: 43D2047251
  • Facility Name: SANFORD CLINIC FAMILY MEDICINE BRANDON
  • Facility Address: 1105 EAST HOLLY BLVD
    BRANDON, SD
    ZIP 57005
  • Facility Phone: 605 582-5820
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: NICOLAS VAN ES
  • NPI Number: 1073536066
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 43D2047251
LAB Type Physician Office
Facility Name SANFORD CLINIC FAMILY MEDICINE BRANDON
Street 1105 EAST HOLLY BLVD
City BRANDON
State SD
ZIP 57005
Phone 605 582-5820
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/20/2024
Certificate Expiration Date 9/19/2026
Facility Type Physician Office
Lab Director NICOLAS VAN ES

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