16D2116232 CLIA NUMBER - MERCY PHYSICIAN ASSOCIATES, INC DBA MERCYCARE PRAIRIE CREEK

Laboratory Demographics

  • CLIA Code: 16D2116232
  • Facility Name: MERCY PHYSICIAN ASSOCIATES, INC DBA MERCYCARE PRAIRIE CREEK
  • Facility Address: 777 76TH AVENUE DRIVE SW
    CEDAR RAPIDS, IA
    ZIP 52404
  • Facility Phone: 319 558-0350
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MICHAEL GOMENDOZA
  • NPI Number: 1255886388
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 16D2116232
LAB Type Physician Office
Facility Name MERCY PHYSICIAN ASSOCIATES, INC DBA MERCYCARE PRAIRIE CREEK
Street 777 76TH AVENUE DRIVE SW
City CEDAR RAPIDS
State IA
ZIP 52404
Phone 319 558-0350
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/21/2024
Certificate Expiration Date 7/20/2026
Facility Type Physician Office
Lab Director MICHAEL GOMENDOZA

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