26D0929943 CLIA NUMBER - CRISANTO GUALBERTO MD

Laboratory Demographics

  • CLIA Code: 26D0929943
  • Facility Name: CRISANTO GUALBERTO MD
  • Facility Address: 106 WEST STATE STREET
    VANDALIA, MO
    ZIP 63382
  • Facility Phone: 573 594-6208
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: CRISANTO S. GUALBERTO MD
  • NPI Number: 1043285398
  • Taxonomy: 208D00000X - General Practice

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CLIA Record

Field Name Field Value
CLIA Number 26D0929943
LAB Type Physician Office
Facility Name CRISANTO GUALBERTO MD
Street 106 WEST STATE STREET
City VANDALIA
State MO
ZIP 63382
Phone 573 594-6208
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 6/28/2025
Certificate Expiration Date 6/27/2027
Facility Type Physician Office
Lab Director CRISANTO S. GUALBERTO MD

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