16D2070408 CLIA NUMBER - SOUTHCREST MANOR II

Laboratory Demographics

  • CLIA Code: 16D2070408
  • Facility Name: SOUTHCREST MANOR II
  • Facility Address: 602 2ND STREET SW
    WAUKON, IA
    ZIP 52172
  • Facility Phone: 563 568-4207
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: LOU ANN WIKAN
  • NPI Number: 1952738502
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 16D2070408
LAB Type Assisted Living Facility
Facility Name SOUTHCREST MANOR II
Street 602 2ND STREET SW
City WAUKON
State IA
ZIP 52172
Phone 563 568-4207
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/16/2023
Certificate Expiration Date 12/15/2025
Facility Type Assisted Living Facility
Lab Director LOU ANN WIKAN

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