26D0679044 CLIA NUMBER - TCMH FAMILY CLINIC - LICKING

Laboratory Demographics

  • CLIA Code: 26D0679044
  • Facility Name: TCMH FAMILY CLINIC - LICKING
  • Facility Address: 139 W HWY 32
    LICKING, MO
    ZIP 65542
  • Facility Phone: 573 674-3011
  • Facility Type: Rural Health Clinic
  • Facility Type: Microscopy
  • Lab Director: WHITNEY J. HALL
  • NPI Number: 1235178930
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 26D0679044
LAB Type Rural Health Clinic
Facility Name TCMH FAMILY CLINIC - LICKING
Street 139 W HWY 32
City LICKING
State MO
ZIP 65542
Phone 573 674-3011
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 9/16/2025
Certificate Expiration Date 9/15/2027
Facility Type Rural Health Clinic
Lab Director WHITNEY J. HALL

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