26D0929220 CLIA NUMBER - MERCY CLINIC PEDIATRICS - FENTON

Laboratory Demographics

  • CLIA Code: 26D0929220
  • Facility Name: MERCY CLINIC PEDIATRICS - FENTON
  • Facility Address: 1203 SMIZER MILL ROAD ST 108
    FENTON, MO
    ZIP 63026
  • Facility Phone: 636 717-1340
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: STEPHEN H. THIERAUF
  • NPI Number: 1467648634
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 26D0929220
LAB Type Physician Office
Facility Name MERCY CLINIC PEDIATRICS - FENTON
Street 1203 SMIZER MILL ROAD ST 108
City FENTON
State MO
ZIP 63026
Phone 636 717-1340
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/9/2025
Certificate Expiration Date 6/8/2027
Facility Type Physician Office
Lab Director STEPHEN H. THIERAUF

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