16D0385758 CLIA NUMBER - BETHANY LUTHERAN HOME

Laboratory Demographics

  • CLIA Code: 16D0385758
  • Facility Name: BETHANY LUTHERAN HOME
  • Facility Address: SEVEN ELLIOTT STREET
    COUNCIL BLUFFS, IA
    ZIP 51503
  • Facility Phone: 712 328-9500
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: CHANDRA GUSTAFSON
  • NPI Number: 1003807280
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 16D0385758
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name BETHANY LUTHERAN HOME
Street SEVEN ELLIOTT STREET
City COUNCIL BLUFFS
State IA
ZIP 51503
Phone 712 328-9500
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director CHANDRA GUSTAFSON

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