16D1096521 CLIA NUMBER - AIR EVAC 59 AIR EVAC EMS, INC

Laboratory Demographics

  • CLIA Code: 16D1096521
  • Facility Name: AIR EVAC 59 AIR EVAC EMS, INC
  • Facility Address: 5433 AVENUE O
    FORT MADISON, IA
    ZIP 52627
  • Facility Phone: 319 372-2725
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: MIKE KOENIG
  • NPI Number: 1063490407
  • Taxonomy: 3416A0800X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 16D1096521
LAB Type Ambulance
Facility Name AIR EVAC 59 AIR EVAC EMS, INC
Street 5433 AVENUE O
City FORT MADISON
State IA
ZIP 52627
Phone 319 372-2725
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/6/2025
Certificate Expiration Date 3/5/2027
Facility Type Ambulance
Lab Director MIKE KOENIG

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