16D2150049 CLIA NUMBER - SULLY FIRE AND AMBULANCE

Laboratory Demographics

  • CLIA Code: 16D2150049
  • Facility Name: SULLY FIRE AND AMBULANCE
  • Facility Address: 601 5TH STREET
    SULLY, IA
    ZIP 50251
  • Facility Phone: 641 891-4088
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: JUSTINE L. WYMA
  • NPI Number: 1750374583
  • Taxonomy: 3416L0300X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 16D2150049
LAB Type Ambulance
Facility Name SULLY FIRE AND AMBULANCE
Street 601 5TH STREET
City SULLY
State IA
ZIP 50251
Phone 641 891-4088
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/15/2024
Certificate Expiration Date 6/14/2026
Facility Type Ambulance
Lab Director JUSTINE L. WYMA

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