16D0855682 CLIA NUMBER - MERCYONE GRAND AVENUE FAMILY MEDICINE

Laboratory Demographics

  • CLIA Code: 16D0855682
  • Facility Name: MERCYONE GRAND AVENUE FAMILY MEDICINE
  • Facility Address: 1525 GRAND AVENUE
    WEST DES MOINES, IA
    ZIP 50265
  • Facility Phone: 515 226-0112
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: LONDON MUSE
  • NPI Number: 1861749335
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 16D0855682
LAB Type Physician Office
Facility Name MERCYONE GRAND AVENUE FAMILY MEDICINE
Street 1525 GRAND AVENUE
City WEST DES MOINES
State IA
ZIP 50265
Phone 515 226-0112
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/1/2025
Certificate Expiration Date 12/31/2026
Facility Type Physician Office
Lab Director LONDON MUSE

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