16D2193700 CLIA NUMBER - AVOCA LODGE ASSISTED LIVING

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Laboratory Demographics

CLIA Number: 16D2193700

Facility Name: AVOCA LODGE ASSISTED LIVING

Facility Address:
612 E YORK RD
AVOCA, IA
ZIP 51521
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Facility Phone Number: 712 343-2400

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1437206190

Taxonomy: 310400000X - Assisted Living Facility
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

CLIA Record

Field Name	Field Value
CLIA Number	16D2193700
LAB Type	Assisted Living Facility
Facility Name	AVOCA LODGE ASSISTED LIVING
Street	612 E YORK RD
City	AVOCA
State	IA
ZIP	51521
Phone	712 343-2400
CertificateType	4
CertificateEffectiveDate	9/24/2022
CertificateExpirationDate	9/23/2024
FacilityType	Waiver

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