26D0943616 CLIA NUMBER - LAURA WAGNER MD

Laboratory Demographics

  • CLIA Code: 26D0943616
  • Facility Name: LAURA WAGNER MD
  • Facility Address: 14377 WOODLAKE DRIVE, STE 111
    TOWN AND COUNTRY, MO
    ZIP 63017
  • Facility Phone: 314 434-1111
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: LAURA WAGNER MD
  • NPI Number: 1669445060
  • Taxonomy: 174400000X - Specialist

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 26D0943616
LAB Type Physician Office
Facility Name LAURA WAGNER MD
Street 14377 WOODLAKE DRIVE, STE 111
City TOWN AND COUNTRY
State MO
ZIP 63017
Phone 314 434-1111
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 3/31/2024
Certificate Expiration Date 3/30/2026
Facility Type Physician Office
Lab Director LAURA WAGNER MD

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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