16D0884115 CLIA NUMBER - POTTAWATTAMIE COUNTY WIC

Laboratory Demographics

  • CLIA Code: 16D0884115
  • Facility Name: POTTAWATTAMIE COUNTY WIC
  • Facility Address: 300 W BROADWAY SUITE #9
    COUNCIL BLUFFS, IA
    ZIP 51503
  • Facility Phone: 712 328-5886
  • Facility Type: Other
  • Facility Type: Waiver
  • Lab Director: MS. KRISTINE WOOD
  • NPI Number: 1053881102
  • Taxonomy: 251K00000X - Public Health or Welfare

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CLIA Record

Field Name Field Value
CLIA Number 16D0884115
LAB Type Other
Facility Name POTTAWATTAMIE COUNTY WIC
Street 300 W BROADWAY SUITE #9
City COUNCIL BLUFFS
State IA
ZIP 51503
Phone 712 328-5886
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/25/2024
Certificate Expiration Date 3/24/2026
Facility Type Other
Lab Director MS. KRISTINE WOOD

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This page was last updated on: 3/20/2025