16D0385099 CLIA NUMBER - BURGESS FAMILY CLINIC-MAPLETON

Laboratory Demographics

CLIA Number: 16D0385099

Facility Name: BURGESS FAMILY CLINIC-MAPLETON

Facility Address:
513 S MUCKEY STREET
MAPLETON, IA
ZIP 51034
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Facility Phone Number: 712 882-2234

Facility Type: Rural Health Clinic

Certificate Type: Waiver

NPI Number: 1588991962

Taxonomy: 261QR1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	16D0385099
LAB Type	Rural Health Clinic
Facility Name	BURGESS FAMILY CLINIC-MAPLETON
Street	513 S MUCKEY STREET
City	MAPLETON
State	IA
ZIP	51034
Phone	712 882-2234
CertificateType	4
CertificateEffectiveDate	8/17/2022
CertificateExpirationDate	8/16/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024