16D2134535 CLIA NUMBER - UNIVERSITY OF IOWA SPORTS MEDICINE CLINIC

Laboratory Demographics

CLIA Number: 16D2134535

Facility Name: UNIVERSITY OF IOWA SPORTS MEDICINE CLINIC

Facility Address:
2701 PRAIRIE MEADOW DRIVE
IOWA CITY, IA
ZIP 52242
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Facility Phone Number: 319 384-7070

Facility Type: Community Clinic

Certificate Type: Waiver

NPI Number: 1093790578

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	16D2134535
LAB Type	Community Clinic
Facility Name	UNIVERSITY OF IOWA SPORTS MEDICINE CLINIC
Street	2701 PRAIRIE MEADOW DRIVE
City	IOWA CITY
State	IA
ZIP	52242
Phone	319 384-7070
CertificateType	4
CertificateEffectiveDate	8/4/2023
CertificateExpirationDate	8/3/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024