16D1076649 CLIA NUMBER - SIOUXLAND PACE

Laboratory Demographics

CLIA Code: 16D1076649
Facility Name: SIOUXLAND PACE
Facility Address: 1200 TRI-VIEW AVE
SIOUX CITY, IA
ZIP 51103
Facility Phone: 712 224-7223
Facility Type: Other
Facility Type: Waiver
Lab Director: JONI OGDEN
NPI Number: 1669645578
Taxonomy: 251T00000X - Program of All-Inclusive Care for the Elderly (PACE) Provider Organization

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CLIA Record

Field Name	Field Value
CLIA Number	16D1076649
LAB Type	Other
Facility Name	SIOUXLAND PACE
Street	1200 TRI-VIEW AVE
City	SIOUX CITY
State	IA
ZIP	51103
Phone	712 224-7223
Certificate Type	Certificate of Waiver
Certificate Type Description	This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date	11/19/2023
Certificate Expiration Date	11/18/2025
Facility Type	Other
Lab Director	JONI OGDEN

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