Organization
SANFORD SCHOOL OF MEDICINE THE UNIVERSITY OF SD CLINICAL VIROLOG LAB
Active
Organization
SANFORD SCHOOL OF MEDICINE THE UNIVERSITY OF SD CLINICAL VIROLOG LAB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL R KOCH M.D. (DEPT. CHAIR)
(605) 336-3230
Entity
Organization
Contact information
Practice address
2501 W 22ND ST, SIOUX FALLS, SD 57105-1305
(605) 333-5399
(605) 333-5399
Mailing address
1400 W 22ND ST, SIOUX FALLS, SD 57105-1505
(605) 357-1380
(605) 357-1548
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0077920
BLUECROSS AND BLUESHIELD
SD
05
—
5580870
—
SD
Enumeration date
10/02/2006
Last updated
08/22/2020
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