16D0713693 CLIA NUMBER - METHODIST MANOR

Laboratory Demographics

  • CLIA Code: 16D0713693
  • Facility Name: METHODIST MANOR
  • Facility Address: 1206 W FOURTH STREET
    STORM LAKE, IA
    ZIP 50588
  • Facility Phone: 712 732-1120
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: MS. TINA SHANNON
  • NPI Number: 1184709115
  • Taxonomy: 313M00000X - Nursing Facility/Intermediate Care Facility

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CLIA Record

Field Name Field Value
CLIA Number 16D0713693
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name METHODIST MANOR
Street 1206 W FOURTH STREET
City STORM LAKE
State IA
ZIP 50588
Phone 712 732-1120
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 MS. TINA SHANNON

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