26D0706817 CLIA NUMBER - LA PLATA FAMILY PRACTICE CLINIC

Laboratory Demographics

CLIA Number: 26D0706817

Facility Name: LA PLATA FAMILY PRACTICE CLINIC

Facility Address:
201 S GEX ST
LA PLATA, MO
ZIP 63549
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Facility Phone Number: 660 332-4312

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1023154168

Taxonomy: 3336C0003X - Pharmacy
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

CLIA Record

Field Name	Field Value
CLIA Number	26D0706817
LAB Type	Physician Office
Facility Name	LA PLATA FAMILY PRACTICE CLINIC
Street	201 S GEX ST
City	LA PLATA
State	MO
ZIP	63549
Phone	660 332-4312
CertificateType	4
CertificateEffectiveDate	11/5/2023
CertificateExpirationDate	11/4/2025
FacilityType	Waiver

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