26D1003101 CLIA NUMBER - POPLAR BLUFF WELLNESS CLINIC

Laboratory Demographics

  • CLIA Code: 26D1003101
  • Facility Name: POPLAR BLUFF WELLNESS CLINIC
  • Facility Address: 930 NORTH WESTWOOD BLVD
    POPLAR BLUFF, MO
    ZIP 63901
  • Facility Phone: 573 778-1620
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DOROTHY M. MUNCH MD
  • NPI Number: 1952550485
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 26D1003101
LAB Type Physician Office
Facility Name POPLAR BLUFF WELLNESS CLINIC
Street 930 NORTH WESTWOOD BLVD
City POPLAR BLUFF
State MO
ZIP 63901
Phone 573 778-1620
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 12/10/2024
Certificate Expiration Date 12/9/2026
Facility Type Physician Office
Lab Director DOROTHY M. MUNCH MD

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