16D2177022 CLIA NUMBER - PHS WALNUT RIDGE LLC

Laboratory Demographics

  • CLIA Code: 16D2177022
  • Facility Name: PHS WALNUT RIDGE LLC
  • Facility Address: 1703 CAMPUS DRIVE
    CLIVE, IA
    ZIP 50325
  • Facility Phone: (515) 457-1111
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: ALLISON N. BASS
  • NPI Number: 1659920320
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 16D2177022
LAB Type Assisted Living Facility
Facility Name PHS WALNUT RIDGE LLC
Street 1703 CAMPUS DRIVE
City CLIVE
State IA
ZIP 50325
Phone 5154571111
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/2/2026
Certificate Expiration Date 1/1/2028
Facility Type Assisted Living Facility
Lab Director ALLISON N. BASS

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This page was last updated on: 5/18/2026