16D1013211 CLIA NUMBER - CHICKASAW COUNTY PUBLIC HEALTH

Laboratory Demographics

CLIA Number: 16D1013211

Facility Name: CHICKASAW COUNTY PUBLIC HEALTH

Facility Address:
260 EAST PROSPECT PO BOX 355
NEW HAMPTON, IA
ZIP 50659
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Facility Phone Number: 641 394-4053

Facility Type: Community Clinic

Certificate Type: Waiver

NPI Number: 1841617578

Taxonomy: 251K00000X - Public Health or Welfare

CLIA Record

Field Name	Field Value
CLIA Number	16D1013211
LAB Type	Community Clinic
Facility Name	CHICKASAW COUNTY PUBLIC HEALTH
Street	260 EAST PROSPECT PO BOX 355
City	NEW HAMPTON
State	IA
ZIP	50659
Phone	641 394-4053
CertificateType	4
CertificateEffectiveDate	6/4/2023
CertificateExpirationDate	6/3/2025
FacilityType	Waiver

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