16D1010142 CLIA NUMBER - QUINCY MEDICAL GROUP- KEOKUK FAMILY PRACTICE

Laboratory Demographics

CLIA Code: 16D1010142
Facility Name: QUINCY MEDICAL GROUP- KEOKUK FAMILY PRACTICE
Facility Address: 1603 MORGAN STREET, SUITE 3
KEOKUK, IA
ZIP 52632
Facility Phone: 319 524-4300
Facility Type: Rural Health Clinic
Facility Type: Waiver
Lab Director: CRAIG DAVENPORT
NPI Number: 1215497730
Taxonomy: 335V00000X - Portable X-ray and/or Other Portable Diagnostic Imaging Supplier

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CLIA Record

Field Name	Field Value
CLIA Number	16D1010142
LAB Type	Rural Health Clinic
Facility Name	QUINCY MEDICAL GROUP- KEOKUK FAMILY PRACTICE
Street	1603 MORGAN STREET, SUITE 3
City	KEOKUK
State	IA
ZIP	52632
Phone	319 524-4300
Certificate Type	Certificate of Waiver
Certificate Type Description	This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date	12/1/2023
Certificate Expiration Date	11/30/2025
Facility Type	Rural Health Clinic
Lab Director	CRAIG DAVENPORT

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