26D1026663 CLIA NUMBER - OCH WELLPOINT FAMILY MEDICAL CLINIC

Laboratory Demographics

CLIA Number: 26D1026663

Facility Name: OCH WELLPOINT FAMILY MEDICAL CLINIC

Facility Address:
543 W HUBBLE DR
MARSHFIELD, MO
ZIP 65706
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Facility Phone Number: 417 859-4878

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1225338155

Taxonomy: 261QR1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	26D1026663
LAB Type	Physician Office
Facility Name	OCH WELLPOINT FAMILY MEDICAL CLINIC
Street	543 W HUBBLE DR
City	MARSHFIELD
State	MO
ZIP	65706
Phone	417 859-4878
CertificateType	4
CertificateEffectiveDate	6/10/2022
CertificateExpirationDate	6/9/2024
FacilityType	Waiver

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