16D1045049 CLIA NUMBER - JERSEY RIDGE PLACE RETIREMENT COMMUNITY

Laboratory Demographics

  • CLIA Code: 16D1045049
  • Facility Name: JERSEY RIDGE PLACE RETIREMENT COMMUNITY
  • Facility Address: 5605 JERSEY RIDGE ROAD
    DAVENPORT, IA
    ZIP 52807
  • Facility Phone: (563) 355-2027
  • Facility Type: Other
  • Facility Type: Waiver
  • Lab Director: NIKI GILLIES
  • NPI Number: 1609058767
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 16D1045049
LAB Type Other
Facility Name JERSEY RIDGE PLACE RETIREMENT COMMUNITY
Street 5605 JERSEY RIDGE ROAD
City DAVENPORT
State IA
ZIP 52807
Phone 5633552027
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/6/2025
Certificate Expiration Date 9/5/2027
Facility Type Other
Lab Director NIKI GILLIES

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This page was last updated on: 5/18/2026