26D0873989 CLIA NUMBER - COXHEALTH CENTER MT VERNON

Laboratory Demographics

CLIA Number: 26D0873989

Facility Name: COXHEALTH CENTER MT VERNON

Facility Address:
10763 HWY 39, STE 200
MOUNT VERNON, MO
ZIP 65712
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Facility Phone Number: 417 466-2875

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1780778449

Taxonomy: 261QR1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	26D0873989
LAB Type	Physician Office
Facility Name	COXHEALTH CENTER MT VERNON
Street	10763 HWY 39, STE 200
City	MOUNT VERNON
State	MO
ZIP	65712
Phone	417 466-2875
CertificateType	4
CertificateEffectiveDate	3/20/2023
CertificateExpirationDate	3/19/2025
FacilityType	Waiver

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