16D2041920 CLIA NUMBER - MMC DBA WELLMAN FAMILY PRACTICE

Laboratory Demographics

  • CLIA Code: 16D2041920
  • Facility Name: MMC DBA WELLMAN FAMILY PRACTICE
  • Facility Address: 217 8TH AVENUE SUITE 3
    WELLMAN, IA
    ZIP 52356
  • Facility Phone: 319 646-2800
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: MEAGAN M. SQUIERS
  • NPI Number: 1093076580
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 16D2041920
LAB Type Physician Office
Facility Name MMC DBA WELLMAN FAMILY PRACTICE
Street 217 8TH AVENUE SUITE 3
City WELLMAN
State IA
ZIP 52356
Phone 319 646-2800
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 6/1/2024
Certificate Expiration Date 5/31/2026
Facility Type Physician Office
Lab Director MEAGAN M. SQUIERS

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