26D0441169 CLIA NUMBER - PIKE COUNTY MEMORIAL HOSPITAL CLINIC- LOUISIANA 3RD FLOOR

Laboratory Demographics

  • CLIA Code: 26D0441169
  • Facility Name: PIKE COUNTY MEMORIAL HOSPITAL CLINIC- LOUISIANA 3RD FLOOR
  • Facility Address: 2305 GEORGIA STREET
    LOUISIANA, MO
    ZIP 63353
  • Facility Phone: 573 754-4584
  • Facility Type: Rural Health Clinic
  • Facility Type: Waiver
  • Lab Director: TRACY M. FITE
  • NPI Number: 1437265311
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 26D0441169
LAB Type Rural Health Clinic
Facility Name PIKE COUNTY MEMORIAL HOSPITAL CLINIC- LOUISIANA 3RD FLOOR
Street 2305 GEORGIA STREET
City LOUISIANA
State MO
ZIP 63353
Phone 573 754-4584
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/29/2024
Certificate Expiration Date 3/28/2026
Facility Type Rural Health Clinic
Lab Director TRACY M. FITE

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