43D2167425 CLIA NUMBER - PRAIRIE ROOTS HEALTH

Laboratory Demographics

  • CLIA Code: 43D2167425
  • Facility Name: PRAIRIE ROOTS HEALTH
  • Facility Address: 5010 SOUTH BROADBAND LN STE 110
    SIOUX FALLS, SD
    ZIP 57108
  • Facility Phone: 605 215-0812
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: JESSICA PEARSON
  • NPI Number: 1184238859
  • Taxonomy: 225100000X - Physical Therapist

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CLIA Record

Field Name Field Value
CLIA Number 43D2167425
LAB Type Practitioner Other
Facility Name PRAIRIE ROOTS HEALTH
Street 5010 SOUTH BROADBAND LN STE 110
City SIOUX FALLS
State SD
ZIP 57108
Phone 605 215-0812
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/15/2024
Certificate Expiration Date 7/14/2026
Facility Type Practitioner Other
Lab Director JESSICA PEARSON

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