16D2231745 CLIA NUMBER - TRI STATE NURSING

Laboratory Demographics

  • CLIA Code: 16D2231745
  • Facility Name: TRI STATE NURSING
  • Facility Address: 4647 STONE AVENUE, ROOM A212
    SIOUX CITY, IA
    ZIP 51106
  • Facility Phone: 712 277-4442
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: SHANNON STEVENSON
  • NPI Number: 1780879403
  • Taxonomy: 251J00000X - Nursing Care

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CLIA Record

Field Name Field Value
CLIA Number 16D2231745
LAB Type Community Clinic
Facility Name TRI STATE NURSING
Street 4647 STONE AVENUE, ROOM A212
City SIOUX CITY
State IA
ZIP 51106
Phone 712 277-4442
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/5/2025
Certificate Expiration Date 8/4/2027
Facility Type Community Clinic
Lab Director SHANNON STEVENSON

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