16D0383111 CLIA NUMBER - PRAIRIE CITY MEDICAL CLINIC

Laboratory Demographics

  • CLIA Code: 16D0383111
  • Facility Name: PRAIRIE CITY MEDICAL CLINIC
  • Facility Address: 404 E 2ND ST
    PRAIRIE CITY, IA
    ZIP 50228
  • Facility Phone: 515 994-2617
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SETH STREETER
  • NPI Number: 1124015037
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 16D0383111
LAB Type Physician Office
Facility Name PRAIRIE CITY MEDICAL CLINIC
Street 404 E 2ND ST
City PRAIRIE CITY
State IA
ZIP 50228
Phone 515 994-2617
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/1/2024
Certificate Expiration Date 11/30/2026
Facility Type Physician Office
Lab Director SETH STREETER

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This page was last updated on: 6/4/2025