16D0982409 CLIA NUMBER - MERCYONE CLEAR LAKE PEDIATRIC & ADOLESCENT CLINIC

Laboratory Demographics

  • CLIA Code: 16D0982409
  • Facility Name: MERCYONE CLEAR LAKE PEDIATRIC & ADOLESCENT CLINIC
  • Facility Address: 401 SOUTH 15TH STREET
    CLEAR LAKE, IA
    ZIP 50428
  • Facility Phone: 641 357-7442
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KENT S. PITZEN
  • NPI Number: 1093720708
  • Taxonomy: 2080A0000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 16D0982409
LAB Type Physician Office
Facility Name MERCYONE CLEAR LAKE PEDIATRIC & ADOLESCENT CLINIC
Street 401 SOUTH 15TH STREET
City CLEAR LAKE
State IA
ZIP 50428
Phone 641 357-7442
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/24/2025
Certificate Expiration Date 1/23/2027
Facility Type Physician Office
Lab Director KENT S. PITZEN

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This page was last updated on: 6/4/2025