26D0861908 CLIA NUMBER - PHELPS HEALTH

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Laboratory Demographics

CLIA Number: 26D0861908

Facility Name: PHELPS HEALTH

Facility Address:
1000 N JEFFERSON ST
SAINT JAMES, MO
ZIP 65559
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Facility Phone Number: 573 265-8840

Facility Type: Rural Health Clinic

Certificate Type: Waiver

NPI Number: 1457799520

Taxonomy: 261QR1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	26D0861908
LAB Type	Rural Health Clinic
Facility Name	PHELPS HEALTH
Street	1000 N JEFFERSON ST
City	SAINT JAMES
State	MO
ZIP	65559
Phone	573 265-8840
CertificateType	4
CertificateEffectiveDate	1/1/2024
CertificateExpirationDate	12/31/2025
FacilityType	Waiver

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