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General NPI Number Information
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NPI Number | 1376134676
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Entity Type | Organization
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Legal Business Name | STATE UNIVERSITY OF IOWA
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Dates
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Enumeration Date | 01/29/2021
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Last Update Date | 01/29/2021
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Provider Practice Location Address
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Address Line | 285 NEWTON RD 5270 CBRB
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City | IOWA CITY
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State | IA
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Zip | 52242
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Country | US
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Telephone | 319-335-6623
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Fax | 319-335-9890
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Provider Business Mailing Address
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Address Line | 285 NEWTON RD 5270 CBRB
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City | IOWA CITY
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State | IA
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Zip | 52242
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Country | US
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Telephone | 319-335-6623
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Fax | 319-335-9890
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Authorized Official
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Title or Position | LAB DIRECTOR
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Name | RICHARD J SMITH
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Credential | MD
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Telephone | 319-335-6623
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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