16D2312316 CLIA NUMBER - PRIORITY HEALTH NORTHWEST PLLC

Laboratory Demographics

  • CLIA Code: 16D2312316
  • Facility Name: PRIORITY HEALTH NORTHWEST PLLC
  • Facility Address: 1800 NORRIS PL
    SPENCER, IA
    ZIP 51301
  • Facility Phone: 712 580-4570
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: PEYTON HANTELMAN
  • NPI Number: 1548096142
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 16D2312316
LAB Type Practitioner Other
Facility Name PRIORITY HEALTH NORTHWEST PLLC
Street 1800 NORRIS PL
City SPENCER
State IA
ZIP 51301
Phone 712 580-4570
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/9/2024
Certificate Expiration Date 10/8/2026
Facility Type Practitioner Other
Lab Director PEYTON HANTELMAN

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