26D0859405 CLIA NUMBER - JOHNSON PEDIATRIC CENTER

Laboratory Demographics

  • CLIA Code: 26D0859405
  • Facility Name: JOHNSON PEDIATRIC CENTER
  • Facility Address: 6973 OLIVE BLVD
    SAINT LOUIS, MO
    ZIP 63130
  • Facility Phone: 314 862-7515
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DENISE R. JOHNSON MD
  • NPI Number: 1790845436
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 26D0859405
LAB Type Physician Office
Facility Name JOHNSON PEDIATRIC CENTER
Street 6973 OLIVE BLVD
City SAINT LOUIS
State MO
ZIP 63130
Phone 314 862-7515
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 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director DENISE R. JOHNSON MD

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