16D2068236 CLIA NUMBER - BLANK CHILDREN'S ADOLESCENT CLINIC

Laboratory Demographics

  • CLIA Code: 16D2068236
  • Facility Name: BLANK CHILDREN'S ADOLESCENT CLINIC
  • Facility Address: 1212 PLEASANT, SUITE 406
    DES MOINES, IA
    ZIP 50309
  • Facility Phone: 515 241-8336
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KEN L. CHEYNE
  • NPI Number: 1063758605
  • Taxonomy: 363LP0200X - Nurse Practitioner

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 16D2068236
LAB Type Physician Office
Facility Name BLANK CHILDREN'S ADOLESCENT CLINIC
Street 1212 PLEASANT, SUITE 406
City DES MOINES
State IA
ZIP 50309
Phone 515 241-8336
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/30/2023
Certificate Expiration Date 10/29/2025
Facility Type Physician Office
Lab Director KEN L. CHEYNE

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