26D0857451 CLIA NUMBER - WASHINGTON UNIVERSITY PEDIATRIC SUBSPECIALTY SERVICES

Laboratory Demographics

CLIA Code: 26D0857451
Facility Name: WASHINGTON UNIVERSITY PEDIATRIC SUBSPECIALTY SERVICES
Facility Address: #1 CHILDRENS PLACE 2 SOUTH 26
SAINT LOUIS, MO
ZIP 63110
Facility Phone: 314 454-2115
Facility Type: Physician Office
Facility Type: Microscopy
Lab Director: CASSANDRA MICHELLE PRUITT
NPI Number: 1427221407
Taxonomy: 332B00000X - Durable Medical Equipment & Medical Supplies

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CLIA Record

Field Name	Field Value
CLIA Number	26D0857451
LAB Type	Physician Office
Facility Name	WASHINGTON UNIVERSITY PEDIATRIC SUBSPECIALTY SERVICES
Street	#1 CHILDRENS PLACE 2 SOUTH 26
City	SAINT LOUIS
State	MO
ZIP	63110
Phone	314 454-2115
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	7/1/2024
Certificate Expiration Date	6/30/2026
Facility Type	Physician Office
Lab Director	CASSANDRA MICHELLE PRUITT

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