16D0688091 CLIA NUMBER - MEDIC EMS OF SCOTT COUNTY

Laboratory Demographics

CLIA Number: 16D0688091

Facility Name: MEDIC EMS OF SCOTT COUNTY

Facility Address:
1204 EAST HIGH STREET
DAVENPORT, IA
ZIP 52803
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Facility Phone Number: 563 323-6806

Facility Type: Ambulance

Certificate Type: Waiver

NPI Number: 1801861950

Taxonomy: 3416L0300X - Ambulance

CLIA Record

Field Name	Field Value
CLIA Number	16D0688091
LAB Type	Ambulance
Facility Name	MEDIC EMS OF SCOTT COUNTY
Street	1204 EAST HIGH STREET
City	DAVENPORT
State	IA
ZIP	52803
Phone	563 323-6806
CertificateType	4
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	Waiver

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