16D2262855 CLIA NUMBER - QV URGENT CARE IA PLLC

Laboratory Demographics

CLIA Number: 16D2262855

Facility Name: QV URGENT CARE IA PLLC

Facility Address:
1501 39TH ST
FORT MADISON, IA
ZIP 52627
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Facility Phone Number: 319 774-7518

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1114643806

Taxonomy: 261QR1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	16D2262855
LAB Type	Physician Office
Facility Name	QV URGENT CARE IA PLLC
Street	1501 39TH ST
City	FORT MADISON
State	IA
ZIP	52627
Phone	319 774-7518
CertificateType	4
CertificateEffectiveDate	6/20/2022
CertificateExpirationDate	6/19/2024
FacilityType	Waiver

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