26D1007104 CLIA NUMBER - BRANSON NEPHROLOGY LLC

Laboratory Demographics

  • CLIA Code: 26D1007104
  • Facility Name: BRANSON NEPHROLOGY LLC
  • Facility Address: 101 SKAGGS ROAD, STE 302
    BRANSON, MO
    ZIP 65616
  • Facility Phone: 417 334-8288
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: JOHN R. MARTINEZ
  • NPI Number: 1427025212
  • Taxonomy: 207RN0300X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 26D1007104
LAB Type Physician Office
Facility Name BRANSON NEPHROLOGY LLC
Street 101 SKAGGS ROAD, STE 302
City BRANSON
State MO
ZIP 65616
Phone 417 334-8288
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 12/9/2024
Certificate Expiration Date 12/8/2026
Facility Type Physician Office
Lab Director JOHN R. MARTINEZ

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