26D1054541 CLIA NUMBER - MERCY CLINIC PRIMARY CARE - SOUTHFORK SUITE 220

Laboratory Demographics

  • CLIA Code: 26D1054541
  • Facility Name: MERCY CLINIC PRIMARY CARE - SOUTHFORK SUITE 220
  • Facility Address: 12700 SOUTHFORK ROAD SUITE 220
    SAINT LOUIS, MO
    ZIP 63128
  • Facility Phone: 314 543-5984
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: EMIR KERIC
  • NPI Number: 1326235375
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 26D1054541
LAB Type Physician Office
Facility Name MERCY CLINIC PRIMARY CARE - SOUTHFORK SUITE 220
Street 12700 SOUTHFORK ROAD SUITE 220
City SAINT LOUIS
State MO
ZIP 63128
Phone 314 543-5984
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/24/2024
Certificate Expiration Date 5/23/2026
Facility Type Physician Office
Lab Director EMIR KERIC

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