16D2162220 CLIA NUMBER - LE GRAND EMS

Laboratory Demographics

CLIA Number: 16D2162220

Facility Name: LE GRAND EMS

Facility Address:
707 W MAIN STREET
LE GRAND, IA
ZIP 50142
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Facility Phone Number: 641 479-2264

Facility Type: Ambulance

Certificate Type: Waiver

NPI Number: 1477185858

Taxonomy: 3416L0300X - Ambulance

CLIA Record

Field Name	Field Value
CLIA Number	16D2162220
LAB Type	Ambulance
Facility Name	LE GRAND EMS
Street	707 W MAIN STREET
City	LE GRAND
State	IA
ZIP	50142
Phone	641 479-2264
CertificateType	4
CertificateEffectiveDate	2/19/2023
CertificateExpirationDate	2/18/2025
FacilityType	Waiver

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