16D2253885 CLIA NUMBER - RIVER VALLEY MEDICAL GROUP

Laboratory Demographics

  • CLIA Code: 16D2253885
  • Facility Name: RIVER VALLEY MEDICAL GROUP
  • Facility Address: 4626 PROGRESS DRIVE SUITE C
    DAVENPORT, IA
    ZIP 52807
  • Facility Phone: 563 551-4200
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RADHIKA KOLLA
  • NPI Number: 1396408290
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 16D2253885
LAB Type Physician Office
Facility Name RIVER VALLEY MEDICAL GROUP
Street 4626 PROGRESS DRIVE SUITE C
City DAVENPORT
State IA
ZIP 52807
Phone 563 551-4200
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/25/2024
Certificate Expiration Date 2/24/2026
Facility Type Physician Office
Lab Director RADHIKA KOLLA

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