NPI 1285964494

Wagner Community Memorial Hospital Avera

Organisation Clinical Medical Laboratory Wagner, SD

Practice location

Address: 513 3rd St SW, Wagner, SD 57380-9675
Phone: (605) 384-3611
Fax: (605) 384-3232
Mailing address: PO Box 280 513 3rd St SW, Wagner, SD 57380-0280

Authorised official

Name: Bryan Slaba
Title: Ceo
Phone: (605) 384-3611

Registered specialties

Clinical Medical Laboratory Primary

Laboratories Taxonomy 291U00000X Licence 43D0407563 (SD)

Other Clinical Medical Laboratory providers in South Dakota →

Registry record

NPI: 1285964494
Entity type: Organization
NPI issued: 11 Jan 2010
Record last updated: 11 Jan 2010

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.