16D0385408 CLIA NUMBER - MERCYONE PRIMGHAR FAMILY MEDICINE CLINIC

Laboratory Demographics

  • CLIA Code: 16D0385408
  • Facility Name: MERCYONE PRIMGHAR FAMILY MEDICINE CLINIC
  • Facility Address: 240 NORTH RERICK AVENUE PO BOX 477
    PRIMGHAR, IA
    ZIP 51245
  • Facility Phone: 712 757-2045
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KELLY POMERENKE
  • NPI Number: 1851327563
  • Taxonomy: 282NC0060X - General Acute Care Hospital

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CLIA Record

Field Name Field Value
CLIA Number 16D0385408
LAB Type Physician Office
Facility Name MERCYONE PRIMGHAR FAMILY MEDICINE CLINIC
Street 240 NORTH RERICK AVENUE PO BOX 477
City PRIMGHAR
State IA
ZIP 51245
Phone 712 757-2045
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/1/2024
Certificate Expiration Date 6/30/2026
Facility Type Physician Office
Lab Director KELLY POMERENKE

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