26D0920174 CLIA NUMBER - HIGGINSVILLE AMBULANCE

Laboratory Demographics

CLIA Code: 26D0920174
Facility Name: HIGGINSVILLE AMBULANCE
Facility Address: 211 WEST 19TH STREET
HIGGINSVILLE, MO
ZIP 64037
Facility Phone: 660 584-3832
Facility Type: Ambulance
Facility Type: Waiver
Lab Director: DOUGLAS W. KENNEY
NPI Number: 1487931358
Taxonomy: 320900000X - Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities

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CLIA Record

Field Name	Field Value
CLIA Number	26D0920174
LAB Type	Ambulance
Facility Name	HIGGINSVILLE AMBULANCE
Street	211 WEST 19TH STREET
City	HIGGINSVILLE
State	MO
ZIP	64037
Phone	660 584-3832
Certificate Type	Certificate of Waiver
Certificate Type Description	This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date	9/25/2024
Certificate Expiration Date	9/24/2026
Facility Type	Ambulance
Lab Director	DOUGLAS W. KENNEY

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