16D0924489 CLIA NUMBER - COTTAGE GROVE PLACE

Laboratory Demographics

  • CLIA Code: 16D0924489
  • Facility Name: COTTAGE GROVE PLACE
  • Facility Address: 2115 FIRST AVENUE SE
    CEDAR RAPIDS, IA
    ZIP 52402
  • Facility Phone: 319 363-2420
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: MICHON SCOTT
  • NPI Number: 1366421281
  • Taxonomy: 313M00000X - Nursing Facility/Intermediate Care Facility

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CLIA Record

Field Name Field Value
CLIA Number 16D0924489
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name COTTAGE GROVE PLACE
Street 2115 FIRST AVENUE SE
City CEDAR RAPIDS
State IA
ZIP 52402
Phone 319 363-2420
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/31/2025
Certificate Expiration Date 1/30/2027
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director MICHON SCOTT

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