16D0889690 CLIA NUMBER - CEDAR VALLEY RANCH, INC

Laboratory Demographics

CLIA Code: 16D0889690
Facility Name: CEDAR VALLEY RANCH, INC
Facility Address: 2591 61ST STREET LANE
VINTON, IA
ZIP 52349
Facility Phone: 319 472-2671
Facility Type: Other
Facility Type: Waiver
Lab Director: LORENE SPENCER
NPI Number: 1518975770
Taxonomy: 320900000X - Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities

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CLIA Record

Field Name	Field Value
CLIA Number	16D0889690
LAB Type	Other
Facility Name	CEDAR VALLEY RANCH, INC
Street	2591 61ST STREET LANE
City	VINTON
State	IA
ZIP	52349
Phone	319 472-2671
Certificate Type	Certificate of Waiver
Certificate Type Description	This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date	8/3/2024
Certificate Expiration Date	8/2/2026
Facility Type	Other
Lab Director	LORENE SPENCER

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