16D0966230 CLIA NUMBER - MERCYONE URBANDALE INTERNAL MEDICINE CLINIC

Laboratory Demographics

  • CLIA Code: 16D0966230
  • Facility Name: MERCYONE URBANDALE INTERNAL MEDICINE CLINIC
  • Facility Address: 4005 NW URBANDALE DRIVE
    URBANDALE, IA
    ZIP 50322
  • Facility Phone: 515 643-9512
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: LAZARO L. RABANG
  • NPI Number: 1063438638
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 16D0966230
LAB Type Physician Office
Facility Name MERCYONE URBANDALE INTERNAL MEDICINE CLINIC
Street 4005 NW URBANDALE DRIVE
City URBANDALE
State IA
ZIP 50322
Phone 515 643-9512
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/24/2025
Certificate Expiration Date 8/23/2027
Facility Type Physician Office
Lab Director LAZARO L. RABANG

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