26D0705571 CLIA NUMBER - COXHEALTH REPUBLIC CLINIC

Laboratory Demographics

  • CLIA Code: 26D0705571
  • Facility Name: COXHEALTH REPUBLIC CLINIC
  • Facility Address: 3203 E OLD STONE AVE
    BROOKLINE STATION, MO
    ZIP 65619
  • Facility Phone: 417 269-3099
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SUSAN E. GRAVES
  • NPI Number: 1972849115
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 26D0705571
LAB Type Physician Office
Facility Name COXHEALTH REPUBLIC CLINIC
Street 3203 E OLD STONE AVE
City BROOKLINE STATION
State MO
ZIP 65619
Phone 417 269-3099
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/26/2023
Certificate Expiration Date 11/25/2025
Facility Type Physician Office
Lab Director SUSAN E. GRAVES

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