26D0890437 CLIA NUMBER - BJC MEDICAL GROUP PRIMARY CARE AT MBMC- SUITE 387C

Laboratory Demographics

  • CLIA Code: 26D0890437
  • Facility Name: BJC MEDICAL GROUP PRIMARY CARE AT MBMC- SUITE 387C
  • Facility Address: 3009 N BALLAS ROAD, SUITE 387C
    SAINT LOUIS, MO
    ZIP 63131
  • Facility Phone: 314 996-5900
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: LILIBETH M. CAYABYAB-LOE
  • NPI Number: 1043386147
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 26D0890437
LAB Type Physician Office
Facility Name BJC MEDICAL GROUP PRIMARY CARE AT MBMC- SUITE 387C
Street 3009 N BALLAS ROAD, SUITE 387C
City SAINT LOUIS
State MO
ZIP 63131
Phone 314 996-5900
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/7/2024
Certificate Expiration Date 6/6/2026
Facility Type Physician Office
Lab Director LILIBETH M. CAYABYAB-LOE

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