16D2105138 CLIA NUMBER - EAGLE RIDGE INDEPENDENT & ASSISTED LIVING

Laboratory Demographics

  • CLIA Code: 16D2105138
  • Facility Name: EAGLE RIDGE INDEPENDENT & ASSISTED LIVING
  • Facility Address: 1329 ACRE STREET
    GUTTENBERG, IA
    ZIP 52052
  • Facility Phone: 563 252-2288
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: KAYLEE RIES
  • NPI Number: 1205200748
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 16D2105138
LAB Type Assisted Living Facility
Facility Name EAGLE RIDGE INDEPENDENT & ASSISTED LIVING
Street 1329 ACRE STREET
City GUTTENBERG
State IA
ZIP 52052
Phone 563 252-2288
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/18/2023
Certificate Expiration Date 11/17/2025
Facility Type Assisted Living Facility
Lab Director KAYLEE RIES

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