16D0385322 CLIA NUMBER - JUNE E NYLEN CANCER CENTER

Laboratory Demographics

CLIA Number: 16D0385322

Facility Name: JUNE E NYLEN CANCER CENTER

Facility Address:
230 NEBRASKA STREET
SIOUX CITY, IA
ZIP 51101
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Facility Phone Number: 712 252-9311

Facility Type: Physician Office

Certificate Type: Accreditation

NPI Number: 1114904604

Taxonomy: 207RH0003X - Internal Medicine
An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.

CLIA Record

Field Name	Field Value
CLIA Number	16D0385322
LAB Type	Physician Office
Facility Name	JUNE E NYLEN CANCER CENTER
Street	230 NEBRASKA STREET
City	SIOUX CITY
State	IA
ZIP	51101
Phone	712 252-9311
CertificateType	1
CertificateEffectiveDate	12/23/2023
CertificateExpirationDate	12/22/2025
FacilityType	Accreditation

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