26D1060566 CLIA NUMBER - INNOVARE HEALTH ADVOCATES

Laboratory Demographics

  • CLIA Code: 26D1060566
  • Facility Name: INNOVARE HEALTH ADVOCATES
  • Facility Address: 9915 KENNERLY, STE J
    SAINT LOUIS, MO
    ZIP 63128
  • Facility Phone: 314 843-4794
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CHARLES J. WILLEY
  • NPI Number: 1477876423
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 26D1060566
LAB Type Physician Office
Facility Name INNOVARE HEALTH ADVOCATES
Street 9915 KENNERLY, STE J
City SAINT LOUIS
State MO
ZIP 63128
Phone 314 843-4794
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/26/2024
Certificate Expiration Date 10/25/2026
Facility Type Physician Office
Lab Director CHARLES J. WILLEY

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