16D0711542 CLIA NUMBER - GOOD SAMARITAN SOCIETY HOME CARE

Laboratory Demographics

  • CLIA Code: 16D0711542
  • Facility Name: GOOD SAMARITAN SOCIETY HOME CARE
  • Facility Address: 1710 LINCOLN AVENUE, SUITE A PO BOX 306
    SPIRIT LAKE, IA
    ZIP 51360
  • Facility Phone: 712 336-3412
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: MARY BREVIK
  • NPI Number: 1841522976
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 16D0711542
LAB Type Home Health Agency
Facility Name GOOD SAMARITAN SOCIETY HOME CARE
Street 1710 LINCOLN AVENUE, SUITE A PO BOX 306
City SPIRIT LAKE
State IA
ZIP 51360
Phone 712 336-3412
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 Home Health Agency
Lab Director MARY BREVIK

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