16D1066873 CLIA NUMBER - LELAND R SMITH ASSISTED LIVING

Laboratory Demographics

  • CLIA Code: 16D1066873
  • Facility Name: LELAND R SMITH ASSISTED LIVING
  • Facility Address: 309 OVESEN DRIVE
    WILTON, IA
    ZIP 52778
  • Facility Phone: 563 732-2086
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: TIFANY RICKEY
  • NPI Number: 1114055910
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 16D1066873
LAB Type Assisted Living Facility
Facility Name LELAND R SMITH ASSISTED LIVING
Street 309 OVESEN DRIVE
City WILTON
State IA
ZIP 52778
Phone 563 732-2086
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/5/2025
Certificate Expiration Date 4/4/2027
Facility Type Assisted Living Facility
Lab Director TIFANY RICKEY

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