26D0445822 CLIA NUMBER - LAKE REGIONAL CLINIC-CAMDENTON

Laboratory Demographics

CLIA Number: 26D0445822

Facility Name: LAKE REGIONAL CLINIC-CAMDENTON

Facility Address:
1930 N BUSINESS HWY 5 UNIT 1 A
CAMDENTON, MO
ZIP 65020
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Facility Phone Number: 573 346-5624

Facility Type: Rural Health Clinic

Certificate Type: Accreditation

NPI Number: 1437440856

Taxonomy: 261QR1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	26D0445822
LAB Type	Rural Health Clinic
Facility Name	LAKE REGIONAL CLINIC-CAMDENTON
Street	1930 N BUSINESS HWY 5 UNIT 1 A
City	CAMDENTON
State	MO
ZIP	65020
Phone	573 346-5624
CertificateType	1
CertificateEffectiveDate	10/7/2022
CertificateExpirationDate	10/6/2024
FacilityType	Accreditation

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This page was last updated on: 4/23/2024