16D0691082 CLIA NUMBER - STORY MEDICAL CLINIC- NEVADA

Laboratory Demographics

CLIA Number: 16D0691082

Facility Name: STORY MEDICAL CLINIC- NEVADA

Facility Address:
640 S 19TH STREET, STE 100
NEVADA, IA
ZIP 50201
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Facility Phone Number: 515 382-5413

Facility Type: Hospital

Certificate Type: Waiver

NPI Number: 1508390352

Taxonomy: 261QR1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	16D0691082
LAB Type	Hospital
Facility Name	STORY MEDICAL CLINIC- NEVADA
Street	640 S 19TH STREET, STE 100
City	NEVADA
State	IA
ZIP	50201
Phone	515 382-5413
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