26D0954574 CLIA NUMBER - SALT RIVER AMBULANCE DISTRICT

Laboratory Demographics

  • CLIA Code: 26D0954574
  • Facility Name: SALT RIVER AMBULANCE DISTRICT
  • Facility Address: 202 NORTH JACKSON
    SHELBYVILLE, MO
    ZIP 63469
  • Facility Phone: 573 633-2335
  • Facility Type: Other
  • Facility Type: Waiver
  • Lab Director: KIETH A. PANTALEO
  • NPI Number: 1609877760
  • Taxonomy: 3416L0300X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 26D0954574
LAB Type Other
Facility Name SALT RIVER AMBULANCE DISTRICT
Street 202 NORTH JACKSON
City SHELBYVILLE
State MO
ZIP 63469
Phone 573 633-2335
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/2/2024
Certificate Expiration Date 12/1/2026
Facility Type Other
Lab Director KIETH A. PANTALEO

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