16D0983169 CLIA NUMBER - POTTAWATTAMIE COUNTY JAIL

Laboratory Demographics

CLIA Number: 16D0983169

Facility Name: POTTAWATTAMIE COUNTY JAIL

Facility Address:
1400 BIG LAKE RD
COUNCIL BLUFFS, IA
ZIP 51501
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Facility Phone Number: 712 890-2246

Facility Type: Rural Health Clinic

Certificate Type: Waiver

NPI Number: 1053881102

Taxonomy: 251K00000X - Public Health or Welfare

CLIA Record

Field Name	Field Value
CLIA Number	16D0983169
LAB Type	Rural Health Clinic
Facility Name	POTTAWATTAMIE COUNTY JAIL
Street	1400 BIG LAKE RD
City	COUNCIL BLUFFS
State	IA
ZIP	51501
Phone	712 890-2246
CertificateType	4
CertificateEffectiveDate	2/16/2023
CertificateExpirationDate	2/15/2025
FacilityType	Waiver

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