16D0700834 CLIA NUMBER - MERCYONE DES MOINES DIABETES & ENDOCRINOLOGY CARE

Laboratory Demographics

CLIA Number: 16D0700834

Facility Name: MERCYONE DES MOINES DIABETES & ENDOCRINOLOGY CARE

Facility Address:
411 LAUREL STREET, SUITE 3262
DES MOINES, IA
ZIP 50314
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Facility Phone Number: 515 643-5111

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1083894463

Taxonomy: 261Q00000X - Clinic/Center
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

CLIA Record

Field Name	Field Value
CLIA Number	16D0700834
LAB Type	Physician Office
Facility Name	MERCYONE DES MOINES DIABETES & ENDOCRINOLOGY CARE
Street	411 LAUREL STREET, SUITE 3262
City	DES MOINES
State	IA
ZIP	50314
Phone	515 643-5111
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