16D0384204 CLIA NUMBER - FRIENDSHIP HAVEN

Laboratory Demographics

  • CLIA Code: 16D0384204
  • Facility Name: FRIENDSHIP HAVEN
  • Facility Address: 420 KENYON ROAD
    FORT DODGE, IA
    ZIP 50501
  • Facility Phone: 515 573-2121
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: LINCOLN WALLACE
  • NPI Number: 1114922481
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 16D0384204
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name FRIENDSHIP HAVEN
Street 420 KENYON ROAD
City FORT DODGE
State IA
ZIP 50501
Phone 515 573-2121
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/30/2025
Certificate Expiration Date 6/29/2027
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director LINCOLN WALLACE

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