16D2189730 CLIA NUMBER - CCRC OF GRIMES, LLC DBA MAGGIE'S PLACE AT KENNYBROOK VILLAGE

Laboratory Demographics

  • CLIA Code: 16D2189730
  • Facility Name: CCRC OF GRIMES, LLC DBA MAGGIE'S PLACE AT KENNYBROOK VILLAGE
  • Facility Address: 230 SW BROOKSIDE DRIVE
    GRIMES, IA
    ZIP 50111
  • Facility Phone: 515 369-3900
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: JAYCE WILSON
  • NPI Number: 1013200914
  • Taxonomy: 314000000X - Skilled Nursing Facility

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 16D2189730
LAB Type Assisted Living Facility
Facility Name CCRC OF GRIMES, LLC DBA MAGGIE'S PLACE AT KENNYBROOK VILLAGE
Street 230 SW BROOKSIDE DRIVE
City GRIMES
State IA
ZIP 50111
Phone 515 369-3900
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/5/2024
Certificate Expiration Date 8/4/2026
Facility Type Assisted Living Facility
Lab Director JAYCE WILSON

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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