16D2174804 CLIA NUMBER - COUNCIL BLUFFS COMPREHENSIVE TREATMENT CENTER

Laboratory Demographics

  • CLIA Code: 16D2174804
  • Facility Name: COUNCIL BLUFFS COMPREHENSIVE TREATMENT CENTER
  • Facility Address: 1750 W BROADWAY
    COUNCIL BLUFFS, IA
    ZIP 51501
  • Facility Phone: 712 215-6588
  • Facility Type: Comp. Outpatient Rehab Facility
  • Facility Type: Waiver
  • Lab Director: GLENN HURST
  • NPI Number: 1326689076
  • Taxonomy: 261QM2800X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 16D2174804
LAB Type Comp. Outpatient Rehab Facility
Facility Name COUNCIL BLUFFS COMPREHENSIVE TREATMENT CENTER
Street 1750 W BROADWAY
City COUNCIL BLUFFS
State IA
ZIP 51501
Phone 712 215-6588
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/8/2023
Certificate Expiration Date 11/7/2025
Facility Type Comp. Outpatient Rehab Facility
Lab Director GLENN HURST

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