43D2137891 CLIA NUMBER - EDGEWOOD MITCHELL LLC

Laboratory Demographics

  • CLIA Code: 43D2137891
  • Facility Name: EDGEWOOD MITCHELL LLC
  • Facility Address: 501 EAST SPRUCE ST
    MITCHELL, SD
    ZIP 57301
  • Facility Phone: 605 996-2730
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: JACKIE WENZ
  • NPI Number: 1770004996
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 43D2137891
LAB Type Assisted Living Facility
Facility Name EDGEWOOD MITCHELL LLC
Street 501 EAST SPRUCE ST
City MITCHELL
State SD
ZIP 57301
Phone 605 996-2730
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/5/2025
Certificate Expiration Date 10/4/2027
Facility Type Assisted Living Facility
Lab Director JACKIE WENZ

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