16D1048810 CLIA NUMBER - VILLISCA MEDICAL CLINIC

Laboratory Demographics

  • CLIA Code: 16D1048810
  • Facility Name: VILLISCA MEDICAL CLINIC
  • Facility Address: 205 NORTH U AVENUE
    VILLISCA, IA
    ZIP 50864
  • Facility Phone: 712 826-4422
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: BRIANNA SCHAFFER
  • NPI Number: 1790758092
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 16D1048810
LAB Type Community Clinic
Facility Name VILLISCA MEDICAL CLINIC
Street 205 NORTH U AVENUE
City VILLISCA
State IA
ZIP 50864
Phone 712 826-4422
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/13/2023
Certificate Expiration Date 12/12/2025
Facility Type Community Clinic
Lab Director BRIANNA SCHAFFER

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This page was last updated on: 6/4/2025