16D0937332 CLIA NUMBER - CARDIOVASCULAR MEDICINE PLLC

Laboratory Demographics

  • CLIA Code: 16D0937332
  • Facility Name: CARDIOVASCULAR MEDICINE PLLC
  • Facility Address: 1236 EAST RUSHOLME STREET
    DAVENPORT, IA
    ZIP 52803
  • Facility Phone: 309 743-6719
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BOUYELLA H. REDDY
  • NPI Number: 1982632907
  • Taxonomy: 207RC0000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 16D0937332
LAB Type Physician Office
Facility Name CARDIOVASCULAR MEDICINE PLLC
Street 1236 EAST RUSHOLME STREET
City DAVENPORT
State IA
ZIP 52803
Phone 309 743-6719
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 Physician Office
Lab Director BOUYELLA H. REDDY

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