26D0955662 CLIA NUMBER - GRAN VILLAS,THE

Laboratory Demographics

  • CLIA Code: 26D0955662
  • Facility Name: GRAN VILLAS,THE
  • Facility Address: 420 LYON DRIVE
    NEOSHO, MO
    ZIP 64850
  • Facility Phone: 417 451-7071
  • Facility Type: Other
  • Facility Type: Waiver
  • Lab Director: TRESSA WILSON
  • NPI Number: 1316017544
  • Taxonomy: 261QA0600X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 26D0955662
LAB Type Other
Facility Name GRAN VILLAS,THE
Street 420 LYON DRIVE
City NEOSHO
State MO
ZIP 64850
Phone 417 451-7071
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/6/2025
Certificate Expiration Date 1/5/2027
Facility Type Other
Lab Director TRESSA WILSON

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