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26D0911257 CLIA NUMBER - CANTON / LAGRANGE FAMILY PRACTICE

Laboratory Demographics

CLIA Number: 26D0911257

Facility Name: CANTON / LAGRANGE FAMILY PRACTICE

Facility Address:
1802 ELM
CANTON, MO
ZIP 63435
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Facility Phone Number: 573 288-5360

Facility Type: Community Clinic

Certificate Type: Microscopy
NPI Number: 1023240793

Taxonomy: 251300000X - Local Education Agency (LEA)
The term local education agency means a public board of education or other public authority legally constituted within a State to either provide administrative control or direction of, or perform a service function for public schools serving individuals ages 0 - 21 in a state, city, county, township, school district, or other political subdivision including a combination of school districts or counties recognized in a State as an administrative agency for its public schools. An LEA may provide, or employ professional who provide, services to children included in the Individuals with Disabilities Education Act (IDEA), such services may include, but are not limited to, such medical services as physical, occupational, and speech therapy.

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
CertificateType 3
CertificateEffectiveDate 4/28/2023
CertificateExpirationDate 4/27/2025
FacilityType PPMP

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