16D2091526 CLIA NUMBER - LOGAN VOLUNTEER FIRE AND RESCUE

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Laboratory Demographics

CLIA Number: 16D2091526

Facility Name: LOGAN VOLUNTEER FIRE AND RESCUE

Facility Address:
112 N 3RD AVENUE
LOGAN, IA
ZIP 51546
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Facility Phone Number: 712 644-2579

Facility Type: Ambulance

Certificate Type: Waiver

NPI Number: 1730296245

Taxonomy: 3416L0300X - Ambulance

CLIA Record

Field Name	Field Value
CLIA Number	16D2091526
LAB Type	Ambulance
Facility Name	LOGAN VOLUNTEER FIRE AND RESCUE
Street	112 N 3RD AVENUE
City	LOGAN
State	IA
ZIP	51546
Phone	712 644-2579
CertificateType	4
CertificateEffectiveDate	2/13/2023
CertificateExpirationDate	2/12/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024