26D0926147 CLIA NUMBER - WUCA-CLOVERLEAF PEDIATRICS

Laboratory Demographics

  • CLIA Code: 26D0926147
  • Facility Name: WUCA-CLOVERLEAF PEDIATRICS
  • Facility Address: 5301 VETERANS MEMORIAL PARKWAY, SUITE 104
    SAINT PETERS, MO
    ZIP 63376
  • Facility Phone: 636 939-3365
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ALLA DORFMAN
  • NPI Number: 1710375928
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 26D0926147
LAB Type Physician Office
Facility Name WUCA-CLOVERLEAF PEDIATRICS
Street 5301 VETERANS MEMORIAL PARKWAY, SUITE 104
City SAINT PETERS
State MO
ZIP 63376
Phone 636 939-3365
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/10/2025
Certificate Expiration Date 4/9/2027
Facility Type Physician Office
Lab Director ALLA DORFMAN

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