26D0903484 CLIA NUMBER - JONATHAN L CLARK MD

Laboratory Demographics

  • CLIA Code: 26D0903484
  • Facility Name: JONATHAN L CLARK MD
  • Facility Address: 1200 E WOODHURST, STE Q200
    SPRINGFIELD, MO
    ZIP 65804
  • Facility Phone: 417 881-5639
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JONATHAN L. CLARK MD
  • NPI Number: 1164415204
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 26D0903484
LAB Type Physician Office
Facility Name JONATHAN L CLARK MD
Street 1200 E WOODHURST, STE Q200
City SPRINGFIELD
State MO
ZIP 65804
Phone 417 881-5639
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/24/2025
Certificate Expiration Date 7/23/2027
Facility Type Physician Office
Lab Director JONATHAN L. CLARK MD

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