16D0387943 CLIA NUMBER - IOWA CANCER SPECIALISTS, PC

Laboratory Demographics

CLIA Number: 16D0387943

Facility Name: IOWA CANCER SPECIALISTS, PC

Facility Address:
1750 E 53RD STREET
DAVENPORT, IA
ZIP 52807
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Facility Phone Number: 563 345-4325

Facility Type: Physician Office

Certificate Type: Certificate of Compliance

NPI Number: 1891803011

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	16D0387943
LAB Type	Physician Office
Facility Name	IOWA CANCER SPECIALISTS, PC
Street	1750 E 53RD STREET
City	DAVENPORT
State	IA
ZIP	52807
Phone	563 345-4325
CertificateType	2
CertificateEffectiveDate	11/23/2023
CertificateExpirationDate	11/22/2025
FacilityType	Compliance

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