26D1005690 CLIA NUMBER - BRANSON CLINIC LLC

Laboratory Demographics

CLIA Number: 26D1005690

Facility Name: BRANSON CLINIC LLC

Facility Address:
110 BUSINESS PARK DRIVE, SUITE A
BRANSON, MO
ZIP 65616
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Facility Phone Number: 417 239-0125

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1326576174

Taxonomy: 261QR1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	26D1005690
LAB Type	Physician Office
Facility Name	BRANSON CLINIC LLC
Street	110 BUSINESS PARK DRIVE, SUITE A
City	BRANSON
State	MO
ZIP	65616
Phone	417 239-0125
CertificateType	3
CertificateEffectiveDate	10/29/2022
CertificateExpirationDate	10/28/2024
FacilityType	PPMP

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This page was last updated on: 4/23/2024