16D2110478 CLIA NUMBER - JACKSON RECOVERY CENTERS-SIOUX CITY OUTPATIENT

Laboratory Demographics

  • CLIA Code: 16D2110478
  • Facility Name: JACKSON RECOVERY CENTERS-SIOUX CITY OUTPATIENT
  • Facility Address: 800 5TH STREET, SUITE 200
    SIOUX CITY, IA
    ZIP 51101
  • Facility Phone: 712 234-2300
  • Facility Type: Other - SUBSTANCE ABUSE TREATMENT
  • Facility Type: Waiver
  • Lab Director: RACHEL WURTH
  • NPI Number: 1811994973
  • Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility

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CLIA Record

Field Name Field Value
CLIA Number 16D2110478
LAB Type Other - SUBSTANCE ABUSE TREATMENT
Facility Name JACKSON RECOVERY CENTERS-SIOUX CITY OUTPATIENT
Street 800 5TH STREET, SUITE 200
City SIOUX CITY
State IA
ZIP 51101
Phone 712 234-2300
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/15/2024
Certificate Expiration Date 3/14/2026
Facility Type Other - SUBSTANCE ABUSE TREATMENT
Lab Director RACHEL WURTH

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