16D2067598 CLIA NUMBER - ROSECRANCE NEW LIFE

Laboratory Demographics

  • CLIA Code: 16D2067598
  • Facility Name: ROSECRANCE NEW LIFE
  • Facility Address: 2322 E KIMBERLY ROAD, SUITE 200 N
    DAVENPORT, IA
    ZIP 52807
  • Facility Phone: 815 387-5620
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: THOMAS E. WRIGHT
  • NPI Number: 1154490985
  • Taxonomy: 261QR0405X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 16D2067598
LAB Type Practitioner Other
Facility Name ROSECRANCE NEW LIFE
Street 2322 E KIMBERLY ROAD, SUITE 200 N
City DAVENPORT
State IA
ZIP 52807
Phone 815 387-5620
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/18/2023
Certificate Expiration Date 10/17/2025
Facility Type Practitioner Other
Lab Director THOMAS E. WRIGHT

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This page was last updated on: 6/4/2025