16D0969483 CLIA NUMBER - MADISON COUNTY AMBULANCE

Laboratory Demographics

CLIA Number: 16D0969483

Facility Name: MADISON COUNTY AMBULANCE

Facility Address:
209 WAMBOLD DR
WINTERSET, IA
ZIP 50273
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Facility Phone Number: 515 462-2253

Facility Type: Ambulance

Certificate Type: Waiver

NPI Number: 1114914819

Taxonomy: 3416L0300X - Ambulance

CLIA Record

Field Name	Field Value
CLIA Number	16D0969483
LAB Type	Ambulance
Facility Name	MADISON COUNTY AMBULANCE
Street	209 WAMBOLD DR
City	WINTERSET
State	IA
ZIP	50273
Phone	515 462-2253
CertificateType	4
CertificateEffectiveDate	1/18/2024
CertificateExpirationDate	1/17/2026
FacilityType	Waiver

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