16D0997905 CLIA NUMBER - WAGGONER PEDIATRICS OF CENTRAL IOWA

Laboratory Demographics

  • CLIA Code: 16D0997905
  • Facility Name: WAGGONER PEDIATRICS OF CENTRAL IOWA
  • Facility Address: 2555 BERKSHIRE PARKWAY SUITE A
    CLIVE, IA
    ZIP 50325
  • Facility Phone: 515 987-0051
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: DR. BRIAN L. WAGGONER
  • NPI Number: 1225572548
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 16D0997905
LAB Type Physician Office
Facility Name WAGGONER PEDIATRICS OF CENTRAL IOWA
Street 2555 BERKSHIRE PARKWAY SUITE A
City CLIVE
State IA
ZIP 50325
Phone 515 987-0051
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 10/9/2024
Certificate Expiration Date 10/8/2026
Facility Type Physician Office
Lab Director DR. BRIAN L. WAGGONER

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