26D0652418 CLIA NUMBER - DOUGLAS COUNTY HEALTH DEPARTMENT

Laboratory Demographics

CLIA Number: 26D0652418

Facility Name: DOUGLAS COUNTY HEALTH DEPARTMENT

Facility Address:
603 SPRINGFIELD RD
AVA, MO
ZIP 65608
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Facility Phone Number: 417 683-4174

Facility Type: Other

Certificate Type: Waiver

NPI Number: 1649253105

Taxonomy: 261QP0905X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	26D0652418
LAB Type	Other
Facility Name	DOUGLAS COUNTY HEALTH DEPARTMENT
Street	603 SPRINGFIELD RD
City	AVA
State	MO
ZIP	65608
Phone	417 683-4174
CertificateType	4
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	Waiver

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