16D0859638 CLIA NUMBER - SCENIC ACRES RESIDENTIAL CARE

Laboratory Demographics

  • CLIA Code: 16D0859638
  • Facility Name: SCENIC ACRES RESIDENTIAL CARE
  • Facility Address: 23105 GRANITE AVENUE
    SAINT OLAF, IA
    ZIP 52072
  • Facility Phone: 563 245-2640
  • Facility Type: Other
  • Facility Type: Waiver
  • Lab Director: LISA PAVLOVEC
  • NPI Number: 1508930660
  • Taxonomy: 311Z00000X - Custodial Care Facility

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CLIA Record

Field Name Field Value
CLIA Number 16D0859638
LAB Type Other
Facility Name SCENIC ACRES RESIDENTIAL CARE
Street 23105 GRANITE AVENUE
City SAINT OLAF
State IA
ZIP 52072
Phone 563 245-2640
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 Other
Lab Director LISA PAVLOVEC

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