16D2165466 CLIA NUMBER - KINGSTON HILL RESIDENTIAL CARE FACILITY

Laboratory Demographics

CLIA Code: 16D2165466
Facility Name: KINGSTON HILL RESIDENTIAL CARE FACILITY
Facility Address: 202 12TH STREET NW
CEDAR RAPIDS, IA
ZIP 52405
Facility Phone: 319 294-5236
Facility Type: Other - RESIDENTIAL CARE FACILITY
Facility Type: Waiver
Lab Director: ALAN WHITTERS
NPI Number: 1861824617
Taxonomy: 320800000X - Community Based Residential Treatment Facility, Mental Illness

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CLIA Record

Field Name	Field Value
CLIA Number	16D2165466
LAB Type	Other - RESIDENTIAL CARE FACILITY
Facility Name	KINGSTON HILL RESIDENTIAL CARE FACILITY
Street	202 12TH STREET NW
City	CEDAR RAPIDS
State	IA
ZIP	52405
Phone	319 294-5236
Certificate Type	Certificate of Waiver
Certificate Type Description	This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date	4/29/2025
Certificate Expiration Date	4/28/2027
Facility Type	Other - RESIDENTIAL CARE FACILITY
Lab Director	ALAN WHITTERS

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