NPIMap

Organization Active NPI

Allen Memorial Hospital Corporation Lab

  • Clinical Medical Laboratory
  • Waterloo, IA
National Provider Identifier
1043816606
Registry record updated Dec 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
ALLEN MEMORIAL HOSPITAL CORPORATION LAB
Practice address
1825 Logan Ave
Waterloo, IA 50703-1916
Phone
(319) 235-3941
NPI assigned
Dec 9, 2020
Last updated
Dec 9, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
ALLEN MEMORIAL HOSPITAL CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 9, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Pamela K Delagardelle
Title
President/Ceo
Phone
(319) 824-5421

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X NU Primary

Addresses

Primary practice location

1825 Logan Ave
Waterloo, IA 50703-1916

Mailing address

1825 Logan Ave
Waterloo, IA 50703-1916
Phone (319) 235-3941

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
16D0384912Allen Memorial Hospital1825 Logan Avenue, Waterloo, IA 50703AccreditationMar 14, 2027
16D0920432Allen Memorial Hospital ER1825 Logan Avenue, Waterloo, IA 50703Certificate of waiverSep 30, 2026

National Provider Directory

National Provider Directory
Tax ID family
John M Zehr MD8 organizations share this tax ID, including this one
Part of
John M Zehr MD

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1607472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607472000000",
    "number": "1043816606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1825 LOGAN AVE",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507031916",
            "telephone_number": "319-235-3941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1825 LOGAN AVE",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507031916",
            "telephone_number": "319-235-3941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLEN MEMORIAL HOSPITAL CORPORATION LAB",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ALLEN MEMORIAL HOSPITAL CORPORATION",
        "enumeration_date": "2020-12-09",
        "last_updated": "2020-12-09",
        "certification_date": "2020-12-09",
        "status": "A",
        "authorized_official_last_name": "DELAGARDELLE",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "319-824-5421"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterloo, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.