WAGNER COMMUNITY CLINIC AVERA
NPI 1285964494
Clinical Medical Laboratory in Wagner, SD

Active since January 11, 2010CLIA Certified · 2 labs
513 3RD ST SW, WAGNER, SD 57380(605) 384-3611(605) 384-3232 Get Directions Write a Review

NPPES record last updated: January 11, 2010. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Wagner Community Clinic Avera NPPES

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

WAGNER COMMUNITY CLINIC AVERA (NPI 1285964494) is a healthcare organization registered as a clinical medical laboratory in Wagner, South Dakota and active in the NPI registry since January 2010. The organization holds 2 active CLIA laboratory certificates and lists Bryan Slaba, Ceo, as its authorized official.

NPPES Registry Identity

NPI1285964494
Entity TypeOrganization
Primary Taxonomy291U00000X
Legal Business NameWAGNER COMMUNITY MEMORIAL HOSPITAL AVERA
Location Address513 3RD ST SWWagner, SD 57380-9675
Mailing AddressPo Box 280, 513 3rd St SwWagner, SD 57380-0280 · (605) 384-3611 · Fax (605) 384-3232
Fax(605) 384-3232
Organization SubpartNo
Authorized OfficialBryan SlabaCeo · (605) 384-3611
Enumeration DateJanuary 11, 2010
NPI 1285964494 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinical Medical LaboratoryLaboratories
Taxonomy Code291U00000X
License Licensed in SD · 43D0407563
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.
513 3RD ST SW, Wagner, SD 57380

Other Names 1

Other NameWagner Community Clinic Avera

Accepted Insurance

CLIA Laboratory Certificates CMS CLIA 2

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 of Accreditation 43D0407563

Wagner Community Memorial Hospital Avera · Wagner, SD
Active · expires Dec 25, 2026
CLIA Number43D0407563
Laboratory TypeHospital
Certificate Effective DateDecember 26, 2024
Certificate Expiration DateDecember 25, 2026
Laboratory DirectorDr. Matthew S. Johnson
Laboratory Phone(605) 384-3611
Laboratory LocationWagner Community Memorial Hospital Avera513 3rd Street SW Attn Danielle Revoir, Wagner, SD 57380
CLIA data matches this NPI record on: Address Name Phone
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Certificate of Waiver 43D0953483

Wagner Community Clinic - Avera · Wagner, SD
Active · expires Nov 2, 2026
CLIA Number43D0953483
Laboratory TypePhysician Office
Certificate Effective DateNovember 3, 2024
Certificate Expiration DateNovember 2, 2026
Laboratory DirectorDanielle Revoir
Laboratory Phone(605) 384-3611
Laboratory LocationWagner Community Clinic - Avera513 SW 3rd Street, Wagner, SD 57380
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only 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.

Nurse Practitioner (Family)
513 3RD ST SW
WAGNER, SD 57380
Social Worker
513 3RD ST SW
WAGNER, SD 57380
Family Medicine
513 3RD ST SW
WAGNER, SD 57380
Nurse Practitioner (Primary Care)
513 3RD ST SW
WAGNER, SD 57380
Nurse Practitioner
513 3RD ST SW
WAGNER, SD 57380
Social Worker (Clinical)
513 3RD ST SW
WAGNER, SD 57380
Nurse Practitioner (Family)
513 3RD ST SW
WAGNER, SD 57380
General Acute Care Hospital (Critical Access)
513 3RD ST SW
WAGNER, SD 57380

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 Wagner Community Memorial Hospital Avera's NPI number?

The NPI number for Wagner Community Memorial Hospital Avera is 1285964494. It was assigned to this organization in the NPPES registry on January 11, 2010. The provider is also known as Wagner Community Clinic Avera.

Where is Wagner Community Memorial Hospital Avera located?

Wagner Community Memorial Hospital Avera is located at 513 3rd St SW, Wagner, SD 57380. The listed phone number is (605) 384-3611.

What is Wagner Community Memorial Hospital Avera's specialty?

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

Does Wagner Community Memorial Hospital Avera hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does Wagner Community Memorial Hospital Avera accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Home State Health, Ambetter from Sunflower Health Plan and Avera Health Plans and 1 other insurer list Wagner Community Memorial Hospital Avera as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Wagner Community Memorial Hospital Avera was last updated on January 11, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.