16D0963126 CLIA NUMBER - WATERFORD FAMILY MEDICINE

Laboratory Demographics

CLIA Number: 16D0963126

Facility Name: WATERFORD FAMILY MEDICINE

Facility Address:
1820 E 54TH STREET SUITE B
DAVENPORT, IA
ZIP 52807
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Facility Phone Number: 563 355-9990

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1942470828

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	16D0963126
LAB Type	Physician Office
Facility Name	WATERFORD FAMILY MEDICINE
Street	1820 E 54TH STREET SUITE B
City	DAVENPORT
State	IA
ZIP	52807
Phone	563 355-9990
CertificateType	3
CertificateEffectiveDate	7/23/2023
CertificateExpirationDate	7/22/2025
FacilityType	PPMP

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