AVERA MEDICAL GROUP BROOKINGS
NPI 1063782373
Clinical Medical Laboratory in Brookings, SD

Active since January 03, 2012CLIA 43D2117626 · Microscopy
400 22ND AVE, BROOKINGS, SD 57006(605) 697-9500 Get Directions Write a Review

NPPES record last updated: January 3, 2012. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Avera Medical Group Brookings NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

AVERA MEDICAL GROUP BROOKINGS (NPI 1063782373) is a healthcare organization registered as a clinical medical laboratory in Brookings, South Dakota and active in the NPI registry since January 2012. The organization holds a CLIA Microscopy certificate valid through August 18, 2026 and lists Julie Norton, Vp Executive, as its authorized official.

NPPES Registry Identity

NPI1063782373
Entity TypeOrganization
Primary Taxonomy291U00000X
Legal Business NameAVERA MCKENNAN
Location Address400 22ND AVEBrookings, SD 57006-2497
Mailing Address400 22nd AveBrookings, SD 57006-2497 · (605) 697-9500
Organization SubpartNo
Authorized OfficialJulie NortonVp Executive · (605) 322-7818
Enumeration DateJanuary 3, 2012
NPI 1063782373 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinical Medical LaboratoryLaboratories
Taxonomy Code291U00000X
Definition
(1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology.
400 22ND AVE, Brookings, SD 57006

Other Names 1

Doing Business AsAvera Medical Group Brookings

Other Identifiers 1

Medicare UPINS42279

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 43D2117626

Avera Medical Group Brookings Specialty Care · Brookings, SD
Active · expires Aug 18, 2026
CLIA Number43D2117626
Laboratory TypePhysician Office
Certificate Effective DateAugust 19, 2024
Certificate Expiration DateAugust 18, 2026
Laboratory DirectorTara Haarsma
Laboratory Phone(605) 696-2700
Laboratory LocationAvera Medical Group Brookings Specialty Care310 22 Nd Avenue, Brookings, SD 57006
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Podiatrist (Foot & Ankle Surgery)
400 22ND AVE
BROOKINGS, SD 57006
Physician Assistant
400 22ND AVE
BROOKINGS, SD 57006
Family Medicine
400 22ND AVE
BROOKING, SD 57006
Physical Therapist
400 22ND AVE
BROOKINGS, SD 57006
Clinic/Center (Multi-Specialty)
400 22ND AVE
BROOKINGS, SD 57006
Physician Assistant
400 22ND AVE
BROOKINGS, SD 57006
Physical Therapist
400 22ND AVE
BROOKINGS, SD 57006
Nurse Practitioner (Family)
400 22ND AVE
BROOKINGS, SD 57006

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Avera Mckennan's NPI number?

The NPI number for Avera Mckennan is 1063782373. It was assigned to this organization in the NPPES registry on January 3, 2012. The provider is doing business as Avera Medical Group Brookings.

Where is Avera Mckennan located?

Avera Mckennan is located at 400 22nd Ave, Brookings, SD 57006. The listed phone number is (605) 697-9500.

What is Avera Mckennan's specialty?

The primary specialty registered for this NPI is Clinical Medical Laboratory with taxonomy code 291U00000X.

Does Avera Mckennan hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 43D2117626) is associated with this NPI, valid through August 18, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Avera Mckennan was last updated on January 3, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.