26D0959413 CLIA NUMBER - FOUR STATES SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 26D0959413
  • Facility Name: FOUR STATES SURGERY CENTER
  • Facility Address: 1905 W 32ND SUITE 201
    JOPLIN, MO
    ZIP 64804
  • Facility Phone: 417 206-7900
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: DANIEL R. OSBORN
  • NPI Number: 1053382929
  • Taxonomy: 367500000X - Nurse Anesthetist, Certified Registered

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CLIA Record

Field Name Field Value
CLIA Number 26D0959413
LAB Type Ambulatory Surgery Center
Facility Name FOUR STATES SURGERY CENTER
Street 1905 W 32ND SUITE 201
City JOPLIN
State MO
ZIP 64804
Phone 417 206-7900
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/31/2024
Certificate Expiration Date 8/30/2026
Facility Type Ambulatory Surgery Center
Lab Director DANIEL R. OSBORN

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