16D2035859 CLIA NUMBER - PEDIATRIC AND ADULT ALLERGY, PC

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Laboratory Demographics

CLIA Number: 16D2035859

Facility Name: PEDIATRIC AND ADULT ALLERGY, PC

Facility Address:
1212 PLEASANT STREET, SUITE 110
DES MOINES, IA
ZIP 50309
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Facility Phone Number: 515 244-7229

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1609932201

Taxonomy: 207KA0200X - Allergy & Immunology
A physician who specializes in the diagnosis, treatment, and management of allergies. Source: National Uniform Claim Committee

CLIA Record

Field Name	Field Value
CLIA Number	16D2035859
LAB Type	Physician Office
Facility Name	PEDIATRIC AND ADULT ALLERGY, PC
Street	1212 PLEASANT STREET, SUITE 110
City	DES MOINES
State	IA
ZIP	50309
Phone	515 244-7229
CertificateType	4
CertificateEffectiveDate	1/26/2024
CertificateExpirationDate	1/25/2026
FacilityType	Waiver

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