43D2094413 CLIA NUMBER - AVERA AT HOME

Laboratory Demographics

  • CLIA Code: 43D2094413
  • Facility Name: AVERA AT HOME
  • Facility Address: 5300 SOUTH BROADBAND LANE
    SIOUX FALLS, SD
    ZIP 57108
  • Facility Phone: 605 322-3370
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: JILL CRAGOE
  • NPI Number: 1649691320
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 43D2094413
LAB Type Home Health Agency
Facility Name AVERA AT HOME
Street 5300 SOUTH BROADBAND LANE
City SIOUX FALLS
State SD
ZIP 57108
Phone 605 322-3370
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/16/2025
Certificate Expiration Date 4/15/2027
Facility Type Home Health Agency
Lab Director JILL CRAGOE

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This page was last updated on: 6/4/2025