26D1063544 CLIA NUMBER - MERCY CLINIC PRIMARY CARE - OLIVETTE SATELLITE

Laboratory Demographics

  • CLIA Code: 26D1063544
  • Facility Name: MERCY CLINIC PRIMARY CARE - OLIVETTE SATELLITE
  • Facility Address: 9338 OLIVE BLVD, SUITE 100B
    SAINT LOUIS, MO
    ZIP 63132
  • Facility Phone: 314 481-7030
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ALEXANDER RUDOI
  • NPI Number: 1235389859
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 26D1063544
LAB Type Physician Office
Facility Name MERCY CLINIC PRIMARY CARE - OLIVETTE SATELLITE
Street 9338 OLIVE BLVD, SUITE 100B
City SAINT LOUIS
State MO
ZIP 63132
Phone 314 481-7030
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/17/2025
Certificate Expiration Date 1/16/2027
Facility Type Physician Office
Lab Director ALEXANDER RUDOI

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