43D2168195 CLIA NUMBER - AVANTARA NORTH

Laboratory Demographics

  • CLIA Code: 43D2168195
  • Facility Name: AVANTARA NORTH
  • Facility Address: 1620 NORTH 7TH ST
    RAPID CITY, SD
    ZIP 57701
  • Facility Phone: 605 343-4958
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: HEATHER GAVITT
  • NPI Number: 1770149833
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 43D2168195
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name AVANTARA NORTH
Street 1620 NORTH 7TH ST
City RAPID CITY
State SD
ZIP 57701
Phone 605 343-4958
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/24/2025
Certificate Expiration Date 6/23/2027
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director HEATHER GAVITT

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