16D2134355 CLIA NUMBER - JENNIFER DENHARTOG OD LLC

Laboratory Demographics

  • CLIA Code: 16D2134355
  • Facility Name: JENNIFER DENHARTOG OD LLC
  • Facility Address: 12695 UNIVERSITY AVE, SUITE 170
    CLIVE, IA
    ZIP 50325
  • Facility Phone: 515 512-1444
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JENNIFER L. DENHARTOG
  • NPI Number: 1285682245
  • Taxonomy: 152W00000X - Optometrist

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CLIA Record

Field Name Field Value
CLIA Number 16D2134355
LAB Type Physician Office
Facility Name JENNIFER DENHARTOG OD LLC
Street 12695 UNIVERSITY AVE, SUITE 170
City CLIVE
State IA
ZIP 50325
Phone 515 512-1444
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/1/2025
Certificate Expiration Date 7/31/2027
Facility Type Physician Office
Lab Director JENNIFER L. DENHARTOG

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