26D0441289 CLIA NUMBER - FAMILY MEDICAL GROUP

Laboratory Demographics

  • CLIA Code: 26D0441289
  • Facility Name: FAMILY MEDICAL GROUP
  • Facility Address: 201 FIRST EXECUTIVE AVE
    SAINT PETERS, MO
    ZIP 63376
  • Facility Phone: 573 559-3591
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SHAWN K. BRUNK
  • NPI Number: 1023137957
  • Taxonomy: 207Q00000X - Family Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 26D0441289
LAB Type Physician Office
Facility Name FAMILY MEDICAL GROUP
Street 201 FIRST EXECUTIVE AVE
City SAINT PETERS
State MO
ZIP 63376
Phone 573 559-3591
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director SHAWN K. BRUNK

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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