16D2154316 CLIA NUMBER - IOWA FAMILY PRACTICE

Laboratory Demographics

CLIA Number: 16D2154316

Facility Name: IOWA FAMILY PRACTICE

Facility Address:
315 S IOWA AVE SUITE A
WASHINGTON, IA
ZIP 52353
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Facility Phone Number: 319 461-0130

Facility Type: Practitioner Other

Certificate Type: Waiver

NPI Number: 1801379987

Taxonomy: 363LF0000X - Nurse Practitioner

CLIA Record

Field Name	Field Value
CLIA Number	16D2154316
LAB Type	Practitioner Other
Facility Name	IOWA FAMILY PRACTICE
Street	315 S IOWA AVE SUITE A
City	WASHINGTON
State	IA
ZIP	52353
Phone	319 461-0130
CertificateType	4
CertificateEffectiveDate	9/11/2022
CertificateExpirationDate	9/10/2024
FacilityType	Waiver

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