16D0385992 CLIA NUMBER - MEDICAL CLINIC, LLC

Laboratory Demographics

  • CLIA Code: 16D0385992
  • Facility Name: MEDICAL CLINIC, LLC
  • Facility Address: 710 CENTER STREET
    TABOR, IA
    ZIP 51653
  • Facility Phone: 712 629-2975
  • Facility Type: Rural Health Clinic
  • Facility Type: Accreditation
  • Lab Director: KELLI WOLTEMATH
  • NPI Number: 1841263233
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 16D0385992
LAB Type Rural Health Clinic
Facility Name MEDICAL CLINIC, LLC
Street 710 CENTER STREET
City TABOR
State IA
ZIP 51653
Phone 712 629-2975
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 6/24/2024
Certificate Expiration Date 6/23/2026
Facility Type Rural Health Clinic
Lab Director KELLI WOLTEMATH

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This page was last updated on: 6/4/2025