16D1077890 CLIA NUMBER - SPIRIT LAKE CBOC

Laboratory Demographics

  • CLIA Code: 16D1077890
  • Facility Name: SPIRIT LAKE CBOC
  • Facility Address: 1310 LAKE ST RM 109
    SPIRIT LAKE, IA
    ZIP 51360
  • Facility Phone: 712 336-6400
  • Facility Type: Community Clinic
  • Facility Type: Accreditation
  • Lab Director: JERRY SAN DIEGO
  • NPI Number: 1881874337
  • Taxonomy: 261QV0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 16D1077890
LAB Type Community Clinic
Facility Name SPIRIT LAKE CBOC
Street 1310 LAKE ST RM 109
City SPIRIT LAKE
State IA
ZIP 51360
Phone 712 336-6400
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: 9/29/2025