16D1077879 CLIA NUMBER - SIOUX CITY CBOC

Laboratory Demographics

  • CLIA Code: 16D1077879
  • Facility Name: SIOUX CITY CBOC
  • Facility Address: 1551 INDIAN HILLS DRIVE SUITE 206
    SIOUX CITY, IA
    ZIP 51104
  • Facility Phone: 712 258-4700
  • Facility Type: Community Clinic
  • Facility Type: Accreditation
  • Lab Director: JERRY SAN DIEGO
  • NPI Number: 1346523081
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 16D1077879
LAB Type Community Clinic
Facility Name SIOUX CITY CBOC
Street 1551 INDIAN HILLS DRIVE SUITE 206
City SIOUX CITY
State IA
ZIP 51104
Phone 712 258-4700
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 12/20/2007
Certificate Expiration Date 5/22/2026
Facility Type Community Clinic
Lab Director JERRY SAN DIEGO

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