16D0997633 CLIA NUMBER - VICTOR FAMILY MEDICAL CLINIC

Laboratory Demographics

  • CLIA Code: 16D0997633
  • Facility Name: VICTOR FAMILY MEDICAL CLINIC
  • Facility Address: 709 SECOND STREET
    VICTOR, IA
    ZIP 52347
  • Facility Phone: 319 647-7511
  • Facility Type: Rural Health Clinic
  • Facility Type: Waiver
  • Lab Director: JONATHAN D. NEWBERRY
  • NPI Number: 1679246722
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 16D0997633
LAB Type Rural Health Clinic
Facility Name VICTOR FAMILY MEDICAL CLINIC
Street 709 SECOND STREET
City VICTOR
State IA
ZIP 52347
Phone 319 647-7511
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/28/2025
Certificate Expiration Date 1/27/2027
Facility Type Rural Health Clinic
Lab Director JONATHAN D. NEWBERRY

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