16D2091526 CLIA NUMBER - LOGAN VOLUNTEER FIRE AND RESCUE

Laboratory Demographics

  • CLIA Code: 16D2091526
  • Facility Name: LOGAN VOLUNTEER FIRE AND RESCUE
  • Facility Address: 112 N 3RD AVENUE
    LOGAN, IA
    ZIP 51546
  • Facility Phone: 712 644-2579
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: CASEY CHARBONNEAU
  • NPI Number: 1730296245
  • Taxonomy: 3416L0300X - Ambulance

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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
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/13/2025
Certificate Expiration Date 2/12/2027
Facility Type Ambulance
Lab Director CASEY CHARBONNEAU

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