16D1053402 CLIA NUMBER - CLOVER RIDGE PLACE

Laboratory Demographics

  • CLIA Code: 16D1053402
  • Facility Name: CLOVER RIDGE PLACE
  • Facility Address: 205 EHLERS LANE
    MAQUOKETA, IA
    ZIP 52060
  • Facility Phone: 563 652-2125
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: VALERIE CANBY
  • NPI Number: 1245443928
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 16D1053402
LAB Type Assisted Living Facility
Facility Name CLOVER RIDGE PLACE
Street 205 EHLERS LANE
City MAQUOKETA
State IA
ZIP 52060
Phone 563 652-2125
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/24/2024
Certificate Expiration Date 4/23/2026
Facility Type Assisted Living Facility
Lab Director VALERIE CANBY

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