26D0724338 CLIA NUMBER - WUCA, DBA WUCA GRANT MEDICAL

Laboratory Demographics

  • CLIA Code: 26D0724338
  • Facility Name: WUCA, DBA WUCA GRANT MEDICAL
  • Facility Address: 114 N TAYLOR AVENUE
    SAINT LOUIS, MO
    ZIP 63108
  • Facility Phone: 314 534-8600
  • Facility Type: Physician Office
  • Facility Type: Accreditation
  • Lab Director: EMMANUEL VENKATESAN
  • NPI Number: 1669405544
  • Taxonomy: 261QM1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 26D0724338
LAB Type Physician Office
Facility Name WUCA, DBA WUCA GRANT MEDICAL
Street 114 N TAYLOR AVENUE
City SAINT LOUIS
State MO
ZIP 63108
Phone 314 534-8600
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 8/4/2024
Certificate Expiration Date 8/3/2026
Facility Type Physician Office
Lab Director EMMANUEL VENKATESAN

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This page was last updated on: 3/20/2025