16D2179765 CLIA NUMBER - USRC EASTERN IOWA, LLC DBA MERCY DIALYSIS- PLAZA

Laboratory Demographics

CLIA Number: 16D2179765

Facility Name: USRC EASTERN IOWA, LLC DBA MERCY DIALYSIS- PLAZA

Facility Address:
5264 COUNCIL STREET NE
CEDAR RAPIDS, IA
ZIP 52402
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Facility Phone Number: 319 398-6423

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1104450972

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	16D2179765
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	USRC EASTERN IOWA, LLC DBA MERCY DIALYSIS- PLAZA
Street	5264 COUNCIL STREET NE
City	CEDAR RAPIDS
State	IA
ZIP	52402
Phone	319 398-6423
CertificateType	4
CertificateEffectiveDate	3/2/2024
CertificateExpirationDate	3/1/2026
FacilityType	Waiver

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