26D0909661 CLIA NUMBER - PREMIER FAMILY PHYSICIANS

Laboratory Demographics

CLIA Number: 26D0909661

Facility Name: PREMIER FAMILY PHYSICIANS

Facility Address:
#8 DOCTORS PARK
CAPE GIRARDEAU, MO
ZIP 63703
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Facility Phone Number: 573 651-1333

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1316918949

Taxonomy: 208D00000X - General Practice
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

CLIA Record

Field Name	Field Value
CLIA Number	26D0909661
LAB Type	Physician Office
Facility Name	PREMIER FAMILY PHYSICIANS
Street	#8 DOCTORS PARK
City	CAPE GIRARDEAU
State	MO
ZIP	63703
Phone	573 651-1333
CertificateType	4
CertificateEffectiveDate	11/1/2022
CertificateExpirationDate	10/31/2024
FacilityType	Waiver

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