16D0647975 CLIA NUMBER - SAC COUNTY PHNS

Laboratory Demographics

  • CLIA Code: 16D0647975
  • Facility Name: SAC COUNTY PHNS
  • Facility Address: 116 SOUTH STATE STREET SUITE A
    SAC CITY, IA
    ZIP 50583
  • Facility Phone: 712 662-4785
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: SHELLEY VAUBLE
  • NPI Number: 1538248448
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 16D0647975
LAB Type Home Health Agency
Facility Name SAC COUNTY PHNS
Street 116 SOUTH STATE STREET SUITE A
City SAC CITY
State IA
ZIP 50583
Phone 712 662-4785
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 Home Health Agency
Lab Director SHELLEY VAUBLE

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