16D2264284 CLIA NUMBER - PREMISE HEALTH OF IOWA MEDICAL, PC

Laboratory Demographics

  • CLIA Code: 16D2264284
  • Facility Name: PREMISE HEALTH OF IOWA MEDICAL, PC
  • Facility Address: 7825 6TH STREET SW
    CEDAR RAPIDS, IA
    ZIP 52404
  • Facility Phone: 319 640-1872
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ALBERT RIELLY
  • NPI Number: 1003558057
  • Taxonomy: 261QM1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 16D2264284
LAB Type Physician Office
Facility Name PREMISE HEALTH OF IOWA MEDICAL, PC
Street 7825 6TH STREET SW
City CEDAR RAPIDS
State IA
ZIP 52404
Phone 319 640-1872
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/12/2024
Certificate Expiration Date 7/11/2026
Facility Type Physician Office
Lab Director ALBERT RIELLY

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This page was last updated on: 3/20/2025