43D2161964 CLIA NUMBER - EDGEWOOD RAPID CITY LLC

Laboratory Demographics

  • CLIA Code: 43D2161964
  • Facility Name: EDGEWOOD RAPID CITY LLC
  • Facility Address: 4001 DERBY LANE
    RAPID CITY, SD
    ZIP 57701
  • Facility Phone: 605 718-3600
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: MICHELLE KUHN
  • NPI Number: 1972076024
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 43D2161964
LAB Type Assisted Living Facility
Facility Name EDGEWOOD RAPID CITY LLC
Street 4001 DERBY LANE
City RAPID CITY
State SD
ZIP 57701
Phone 605 718-3600
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/13/2025
Certificate Expiration Date 2/12/2027
Facility Type Assisted Living Facility
Lab Director MICHELLE KUHN

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