26D0881638 CLIA NUMBER - ST LOUIS DEVELOPMENTAL DISABILITIES TREATMENT CTRS

Laboratory Demographics

  • CLIA Code: 26D0881638
  • Facility Name: ST LOUIS DEVELOPMENTAL DISABILITIES TREATMENT CTRS
  • Facility Address: 22 MARR LANE
    SAINT CHARLES, MO
    ZIP 63303
  • Facility Phone: 314 894-5400
  • Facility Type: Intermediate Care Facility for Mentally Retarded
  • Facility Type: Waiver
  • Lab Director: RAMARAO KAZA
  • NPI Number: 1871640540
  • Taxonomy: 163WR0006X - Registered Nurse

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CLIA Record

Field Name Field Value
CLIA Number 26D0881638
LAB Type Intermediate Care Facility for Mentally Retarded
Facility Name ST LOUIS DEVELOPMENTAL DISABILITIES TREATMENT CTRS
Street 22 MARR LANE
City SAINT CHARLES
State MO
ZIP 63303
Phone 314 894-5400
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/13/2024
Certificate Expiration Date 1/12/2026
Facility Type Intermediate Care Facility for Mentally Retarded
Lab Director RAMARAO KAZA

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