26D0446842 CLIA NUMBER - MERCY CLINIC LABORATORY SERVICES - ROLLA

Laboratory Demographics

CLIA Number: 26D0446842

Facility Name: MERCY CLINIC LABORATORY SERVICES - ROLLA

Facility Address:
1605 MARTIN SPRINGS DR, STE 110B
ROLLA, MO
ZIP 65401
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Facility Phone Number: 573 458-6632

Facility Type: Physician Office

Certificate Type: Certificate of Compliance

NPI Number: 1457363806

Taxonomy: 261QR1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	26D0446842
LAB Type	Physician Office
Facility Name	MERCY CLINIC LABORATORY SERVICES - ROLLA
Street	1605 MARTIN SPRINGS DR, STE 110B
City	ROLLA
State	MO
ZIP	65401
Phone	573 458-6632
CertificateType	2
CertificateEffectiveDate	2/6/2023
CertificateExpirationDate	2/5/2025
FacilityType	Compliance

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