16D2035960 CLIA NUMBER - CCRC OF GRIMES, LLC DBA KENNYBROOK VILLAGE

Laboratory Demographics

  • CLIA Code: 16D2035960
  • Facility Name: CCRC OF GRIMES, LLC DBA KENNYBROOK VILLAGE
  • Facility Address: 200 SW BROOKSIDE DRIVE
    GRIMES, IA
    ZIP 50111
  • Facility Phone: 515 369-3900
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: JAYCE WILSON
  • NPI Number: 1013200914
  • Taxonomy: 314000000X - Skilled Nursing Facility

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 16D2035960
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name CCRC OF GRIMES, LLC DBA KENNYBROOK VILLAGE
Street 200 SW BROOKSIDE DRIVE
City GRIMES
State IA
ZIP 50111
Phone 515 369-3900
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/27/2024
Certificate Expiration Date 1/26/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director JAYCE WILSON

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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