26D0709363 CLIA NUMBER - GALLATIN FAMILY MEDICINE

Laboratory Demographics

CLIA Number: 26D0709363

Facility Name: GALLATIN FAMILY MEDICINE

Facility Address:
502 S MAIN
GALLATIN, MO
ZIP 64640
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Facility Phone Number: 660 663-3751

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1235143520

Taxonomy: 261Q00000X - Clinic/Center
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

CLIA Record

Field Name	Field Value
CLIA Number	26D0709363
LAB Type	Physician Office
Facility Name	GALLATIN FAMILY MEDICINE
Street	502 S MAIN
City	GALLATIN
State	MO
ZIP	64640
Phone	660 663-3751
CertificateType	3
CertificateEffectiveDate	7/18/2022
CertificateExpirationDate	7/17/2024
FacilityType	PPMP

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