16D2183652 CLIA NUMBER - THE KEOKUK CLINIC

Laboratory Demographics

  • CLIA Code: 16D2183652
  • Facility Name: THE KEOKUK CLINIC
  • Facility Address: 1603 MORGAN STREET SUITE 2
    KEOKUK, IA
    ZIP 52632
  • Facility Phone: 319 768-3495
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ALEXANDER D. PEDERSON
  • NPI Number: 1184627689
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 16D2183652
LAB Type Physician Office
Facility Name THE KEOKUK CLINIC
Street 1603 MORGAN STREET SUITE 2
City KEOKUK
State IA
ZIP 52632
Phone 319 768-3495
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/7/2024
Certificate Expiration Date 5/6/2026
Facility Type Physician Office
Lab Director ALEXANDER D. PEDERSON

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This page was last updated on: 6/4/2025