16D2309050 CLIA NUMBER - MONOGRAM HEALTH PROFESSIONAL SERVICES OF IOWA PLLC

Laboratory Demographics

  • CLIA Code: 16D2309050
  • Facility Name: MONOGRAM HEALTH PROFESSIONAL SERVICES OF IOWA PLLC
  • Facility Address: 4620 E 53RD ST STE 200
    DAVENPORT, IA
    ZIP 52807
  • Facility Phone: 480 716-4059
  • Facility Type: Other - IN HOME PATIENT CARE
  • Facility Type: Waiver
  • Lab Director: SHAMINDER GUPTA
  • NPI Number: 1285344150
  • Taxonomy: 207RN0300X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 16D2309050
LAB Type Other - IN HOME PATIENT CARE
Facility Name MONOGRAM HEALTH PROFESSIONAL SERVICES OF IOWA PLLC
Street 4620 E 53RD ST STE 200
City DAVENPORT
State IA
ZIP 52807
Phone 480 716-4059
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/8/2024
Certificate Expiration Date 8/7/2026
Facility Type Other - IN HOME PATIENT CARE
Lab Director SHAMINDER GUPTA

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