16D0948534 CLIA NUMBER - EXCEPTIONAL PERSONS INC

Laboratory Demographics

CLIA Number: 16D0948534

Facility Name: EXCEPTIONAL PERSONS INC

Facility Address:
760 ANSBOROUGH AVENUE, PO BOX 4090
WATERLOO, IA
ZIP 50704
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Facility Phone Number: 319 236-1033

Facility Type: Other

Certificate Type: Waiver

NPI Number: 1861567794

Taxonomy: 320900000X - Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities.

CLIA Record

Field Name	Field Value
CLIA Number	16D0948534
LAB Type	Other
Facility Name	EXCEPTIONAL PERSONS INC
Street	760 ANSBOROUGH AVENUE, PO BOX 4090
City	WATERLOO
State	IA
ZIP	50704
Phone	319 236-1033
CertificateType	4
CertificateEffectiveDate	7/13/2022
CertificateExpirationDate	7/12/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024