26D0974018 CLIA NUMBER - CMMP SURGICAL CENTER

Laboratory Demographics

  • CLIA Code: 26D0974018
  • Facility Name: CMMP SURGICAL CENTER
  • Facility Address: 1705 CHRISTY DRIVE SUITE 100
    JEFFERSON CITY, MO
    ZIP 65101
  • Facility Phone: 573 635-7022
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: R MICHITSCH
  • NPI Number: 1528060704
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 26D0974018
LAB Type Ambulatory Surgery Center
Facility Name CMMP SURGICAL CENTER
Street 1705 CHRISTY DRIVE SUITE 100
City JEFFERSON CITY
State MO
ZIP 65101
Phone 573 635-7022
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/25/2024
Certificate Expiration Date 5/24/2026
Facility Type Ambulatory Surgery Center
Lab Director R MICHITSCH

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