16D2140809 CLIA NUMBER - EDENCREST AT BEAVERDALE

Laboratory Demographics

  • CLIA Code: 16D2140809
  • Facility Name: EDENCREST AT BEAVERDALE
  • Facility Address: 3410 BEAVER AVENUE
    DES MOINES, IA
    ZIP 50310
  • Facility Phone: 515 777-5105
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: JACI WILCOX
  • NPI Number: 1427563022
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 16D2140809
LAB Type Assisted Living Facility
Facility Name EDENCREST AT BEAVERDALE
Street 3410 BEAVER AVENUE
City DES MOINES
State IA
ZIP 50310
Phone 515 777-5105
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/30/2023
Certificate Expiration Date 11/29/2025
Facility Type Assisted Living Facility
Lab Director JACI WILCOX

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