16D0648049 CLIA NUMBER - BLACKHAWK LIFE CARE CENTER

Laboratory Demographics

  • CLIA Code: 16D0648049
  • Facility Name: BLACKHAWK LIFE CARE CENTER
  • Facility Address: 73 WEST FIFTH STREET
    LAKE VIEW, IA
    ZIP 51450
  • Facility Phone: 712 657-8527
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: LESLIE JOHNSON
  • NPI Number: 1649242074
  • Taxonomy: 313M00000X - Nursing Facility/Intermediate Care Facility

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CLIA Record

Field Name Field Value
CLIA Number 16D0648049
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name BLACKHAWK LIFE CARE CENTER
Street 73 WEST FIFTH STREET
City LAKE VIEW
State IA
ZIP 51450
Phone 712 657-8527
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 LESLIE JOHNSON

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