16D2187502 CLIA NUMBER - IOWA CLINIC-NORTH ANKENY FAMILY MEDICINE, THE

Laboratory Demographics

  • CLIA Code: 16D2187502
  • Facility Name: IOWA CLINIC-NORTH ANKENY FAMILY MEDICINE, THE
  • Facility Address: 1360 NW 18TH STREET, SUITE 102
    ANKENY, IA
    ZIP 50023
  • Facility Phone: 515 875-9730
  • Facility Type: Other - CLINIC
  • Facility Type: Waiver
  • Lab Director: NEELIMA R. CHENNUPATI
  • NPI Number: 1184056129
  • Taxonomy: 332B00000X - Durable Medical Equipment & Medical Supplies

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CLIA Record

Field Name Field Value
CLIA Number 16D2187502
LAB Type Other - CLINIC
Facility Name IOWA CLINIC-NORTH ANKENY FAMILY MEDICINE, THE
Street 1360 NW 18TH STREET, SUITE 102
City ANKENY
State IA
ZIP 50023
Phone 515 875-9730
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/2/2024
Certificate Expiration Date 7/1/2026
Facility Type Other - CLINIC
Lab Director NEELIMA R. CHENNUPATI

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