16D0887301 CLIA NUMBER - BETHANY HOME

Laboratory Demographics

  • CLIA Code: 16D0887301
  • Facility Name: BETHANY HOME
  • Facility Address: 1005 LINCOLN AVENUE
    DUBUQUE, IA
    ZIP 52001
  • Facility Phone: 563 556-5233
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: SUSAN M. DE MOSS
  • NPI Number: 1053405803
  • Taxonomy: 313M00000X - Nursing Facility/Intermediate Care Facility

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CLIA Record

Field Name Field Value
CLIA Number 16D0887301
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name BETHANY HOME
Street 1005 LINCOLN AVENUE
City DUBUQUE
State IA
ZIP 52001
Phone 563 556-5233
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/9/2024
Certificate Expiration Date 6/8/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director SUSAN M. DE MOSS

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