16D2053517 CLIA NUMBER - CENTER STAGE PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 16D2053517
  • Facility Name: CENTER STAGE PRIMARY CARE
  • Facility Address: 1000 73RD STREET, SUITE 23
    WEST DES MOINES, IA
    ZIP 50265
  • Facility Phone: 515 267-1961
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MALEA JENSEN
  • NPI Number: 1427300623
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 16D2053517
LAB Type Physician Office
Facility Name CENTER STAGE PRIMARY CARE
Street 1000 73RD STREET, SUITE 23
City WEST DES MOINES
State IA
ZIP 50265
Phone 515 267-1961
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/1/2025
Certificate Expiration Date 1/31/2027
Facility Type Physician Office
Lab Director MALEA JENSEN

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