16D0383623 CLIA NUMBER - MERCYONE BEAVERDALE FAMILY MEDICINE CLINIC

Laboratory Demographics

  • CLIA Code: 16D0383623
  • Facility Name: MERCYONE BEAVERDALE FAMILY MEDICINE CLINIC
  • Facility Address: 4326 HICKMAN ROAD SUITE 100
    DES MOINES, IA
    ZIP 50310
  • Facility Phone: 515 271-6333
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ROBERT CALLAHAN
  • NPI Number: 1710903364
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 16D0383623
LAB Type Physician Office
Facility Name MERCYONE BEAVERDALE FAMILY MEDICINE CLINIC
Street 4326 HICKMAN ROAD SUITE 100
City DES MOINES
State IA
ZIP 50310
Phone 515 271-6333
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/15/2025
Certificate Expiration Date 5/14/2027
Facility Type Physician Office
Lab Director ROBERT CALLAHAN

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