43D2164125 CLIA NUMBER - PIERRE OUTPATIENT VA CLINIC

Laboratory Demographics

  • CLIA Code: 43D2164125
  • Facility Name: PIERRE OUTPATIENT VA CLINIC
  • Facility Address: 1615 NORTH HARRISON AVENUE SUITE 20
    PIERRE, SD
    ZIP 57501
  • Facility Phone: 605 945-1710
  • Facility Type: Other - OUTPATIENT VA CLINIC
  • Facility Type: Waiver
  • Lab Director: CHRISTIAN HOLCOMB
  • NPI Number: 1770520397
  • Taxonomy: 261QV0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 43D2164125
LAB Type Other - OUTPATIENT VA CLINIC
Facility Name PIERRE OUTPATIENT VA CLINIC
Street 1615 NORTH HARRISON AVENUE SUITE 20
City PIERRE
State SD
ZIP 57501
Phone 605 945-1710
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/28/2025
Certificate Expiration Date 3/27/2027
Facility Type Other - OUTPATIENT VA CLINIC
Lab Director CHRISTIAN HOLCOMB

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