16D1073042 CLIA NUMBER - HIAWATHA MEDICAL PARK IMAGING CENTER

Laboratory Demographics

  • CLIA Code: 16D1073042
  • Facility Name: HIAWATHA MEDICAL PARK IMAGING CENTER
  • Facility Address: 1195 BOYSON ROAD, SUITE 102
    HIAWATHA, IA
    ZIP 52233
  • Facility Phone: 319 398-6423
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: KIMBERLY A. BAUER
  • NPI Number: 1285630541
  • Taxonomy: 313M00000X - Nursing Facility/Intermediate Care Facility

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CLIA Record

Field Name Field Value
CLIA Number 16D1073042
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name HIAWATHA MEDICAL PARK IMAGING CENTER
Street 1195 BOYSON ROAD, SUITE 102
City HIAWATHA
State IA
ZIP 52233
Phone 319 398-6423
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/29/2023
Certificate Expiration Date 8/28/2025
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director KIMBERLY A. BAUER

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This page was last updated on: 3/20/2025