16D1100809 CLIA NUMBER - CEDAR VALLEY WAVERLY DIALYSIS

Laboratory Demographics

CLIA Number: 16D1100809

Facility Name: CEDAR VALLEY WAVERLY DIALYSIS

Facility Address:
220 10TH STREET SW
WAVERLY, IA
ZIP 50677
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Facility Phone Number: 319 352-8019

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1558505636

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	16D1100809
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	CEDAR VALLEY WAVERLY DIALYSIS
Street	220 10TH STREET SW
City	WAVERLY
State	IA
ZIP	50677
Phone	319 352-8019
CertificateType	4
CertificateEffectiveDate	6/12/2023
CertificateExpirationDate	6/11/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024