26D0444827 CLIA NUMBER - MOUND CITY FAMILY MEDICINE

Laboratory Demographics

  • CLIA Code: 26D0444827
  • Facility Name: MOUND CITY FAMILY MEDICINE
  • Facility Address: 514 STATE STREET
    MOUND CITY, MO
    ZIP 64470
  • Facility Phone: 660 686-2276
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DUSTIN C. CARPENTER
  • NPI Number: 1295865988
  • Taxonomy: 251300000X - Local Education Agency (LEA)

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CLIA Record

Field Name Field Value
CLIA Number 26D0444827
LAB Type Physician Office
Facility Name MOUND CITY FAMILY MEDICINE
Street 514 STATE STREET
City MOUND CITY
State MO
ZIP 64470
Phone 660 686-2276
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director DUSTIN C. CARPENTER

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