43D2093084 CLIA NUMBER - EDGEWOOD PIERRE LLC

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Laboratory Demographics

CLIA Number: 43D2093084

Facility Name: EDGEWOOD PIERRE LLC

Facility Address:
1950 EAST 4TH STREET
PIERRE, SD
ZIP 57501
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Facility Phone Number: 605 494-3400

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1730554577

Taxonomy: 310400000X - Assisted Living Facility
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

CLIA Record

Field Name	Field Value
CLIA Number	43D2093084
LAB Type	Assisted Living Facility
Facility Name	EDGEWOOD PIERRE LLC
Street	1950 EAST 4TH STREET
City	PIERRE
State	SD
ZIP	57501
Phone	605 494-3400
CertificateType	4
CertificateEffectiveDate	3/20/2023
CertificateExpirationDate	3/19/2025
FacilityType	Waiver

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