16D0693157 CLIA NUMBER - PRAIRIE VIEW HOME

Laboratory Demographics

  • CLIA Code: 16D0693157
  • Facility Name: PRAIRIE VIEW HOME
  • Facility Address: 610 EASTERN AVENUE
    SANBORN, IA
    ZIP 51248
  • Facility Phone: 712 729-3228
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: SCOTT LICHTY
  • NPI Number: 1932193059
  • Taxonomy: 313M00000X - Nursing Facility/Intermediate Care Facility

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CLIA Record

Field Name Field Value
CLIA Number 16D0693157
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name PRAIRIE VIEW HOME
Street 610 EASTERN AVENUE
City SANBORN
State IA
ZIP 51248
Phone 712 729-3228
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 SCOTT LICHTY

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