16D2194115 CLIA NUMBER - ELEVATE CCBHC

Laboratory Demographics

  • CLIA Code: 16D2194115
  • Facility Name: ELEVATE CCBHC
  • Facility Address: 405 E 5TH ST
    WATERLOO, IA
    ZIP 50703
  • Facility Phone: 833 370-0719
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: MICHELE JENSEN
  • NPI Number: 1275141350
  • Taxonomy: 261QM0801X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 16D2194115
LAB Type Practitioner Other
Facility Name ELEVATE CCBHC
Street 405 E 5TH ST
City WATERLOO
State IA
ZIP 50703
Phone 833 370-0719
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/28/2024
Certificate Expiration Date 9/27/2026
Facility Type Practitioner Other
Lab Director MICHELE JENSEN

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