26D0695579 CLIA NUMBER - MCPHERSON MEDICAL AND DIAGNOSTICS, LLC DBA ST LOUIS HEALTHCARE GROUP

Laboratory Demographics

CLIA Code: 26D0695579
Facility Name: MCPHERSON MEDICAL AND DIAGNOSTICS, LLC DBA ST LOUIS HEALTHCARE GROUP
Facility Address: 16216 BAXTER ROAD, STE 100
CHESTERFIELD, MO
ZIP 63017
Facility Phone: 636 449-4700
Facility Type: Physician Office
Facility Type: Microscopy
Lab Director: RICHARD C. MUCKERMAN II
NPI Number: 1144074253
Taxonomy: 1223G0001X - Dentist

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CLIA Record

Field Name	Field Value
CLIA Number	26D0695579
LAB Type	Physician Office
Facility Name	MCPHERSON MEDICAL AND DIAGNOSTICS, LLC DBA ST LOUIS HEALTHCARE GROUP
Street	16216 BAXTER ROAD, STE 100
City	CHESTERFIELD
State	MO
ZIP	63017
Phone	636 449-4700
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	11/12/2023
Certificate Expiration Date	11/11/2025
Facility Type	Physician Office
Lab Director	RICHARD C. MUCKERMAN II

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