26D0911257 CLIA NUMBER - CANTON / LAGRANGE FAMILY PRACTICE

Laboratory Demographics

  • CLIA Code: 26D0911257
  • Facility Name: CANTON / LAGRANGE FAMILY PRACTICE
  • Facility Address: 1802 ELM
    CANTON, MO
    ZIP 63435
  • Facility Phone: 573 288-5360
  • Facility Type: Community Clinic
  • Facility Type: Microscopy
  • Lab Director: ADAM SAMARITONI
  • NPI Number: 1023240793
  • Taxonomy: 251300000X - Local Education Agency (LEA)

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CLIA Record

Field Name Field Value
CLIA Number 26D0911257
LAB Type Community Clinic
Facility Name CANTON / LAGRANGE FAMILY PRACTICE
Street 1802 ELM
City CANTON
State MO
ZIP 63435
Phone 573 288-5360
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 4/28/2025
Certificate Expiration Date 4/27/2027
Facility Type Community Clinic
Lab Director ADAM SAMARITONI

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