16D0386861 CLIA NUMBER - MERCYCARE BLAIRS FERRY

Laboratory Demographics

CLIA Number: 16D0386861

Facility Name: MERCYCARE BLAIRS FERRY

Facility Address:
1790 BLAIRS FERRY ROAD
HIAWATHA, IA
ZIP 52233
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Facility Phone Number: 319 378-8362

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1114451424

Taxonomy: 363LF0000X - Nurse Practitioner

CLIA Record

Field Name	Field Value
CLIA Number	16D0386861
LAB Type	Physician Office
Facility Name	MERCYCARE BLAIRS FERRY
Street	1790 BLAIRS FERRY ROAD
City	HIAWATHA
State	IA
ZIP	52233
Phone	319 378-8362
CertificateType	3
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	PPMP

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