16D0382654 CLIA NUMBER - BOONE COUNTY FAMILY MEDICINE SOUTH

Laboratory Demographics

  • CLIA Code: 16D0382654
  • Facility Name: BOONE COUNTY FAMILY MEDICINE SOUTH
  • Facility Address: 1115 SOUTH MARSHALL STREET
    BOONE, IA
    ZIP 50036
  • Facility Phone: 515 433-4866
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: RIENERA SIVESIND
  • NPI Number: 1013061753
  • Taxonomy: 347B00000X - Bus

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CLIA Record

Field Name Field Value
CLIA Number 16D0382654
LAB Type Community Clinic
Facility Name BOONE COUNTY FAMILY MEDICINE SOUTH
Street 1115 SOUTH MARSHALL STREET
City BOONE
State IA
ZIP 50036
Phone 515 433-4866
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/15/2023
Certificate Expiration Date 12/14/2025
Facility Type Community Clinic
Lab Director RIENERA SIVESIND

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