26D1069278 CLIA NUMBER - MERCY CLINIC GASTROENTEROLOGY - 10012 KENNERLY

Laboratory Demographics

  • CLIA Code: 26D1069278
  • Facility Name: MERCY CLINIC GASTROENTEROLOGY - 10012 KENNERLY
  • Facility Address: 10012 KENNERLY RD, SUITE 102
    SAINT LOUIS, MO
    ZIP 63128
  • Facility Phone: 314 543-5911
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: YAZAN ABDALLA
  • NPI Number: 1245652759
  • Taxonomy: 207RG0100X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 26D1069278
LAB Type Physician Office
Facility Name MERCY CLINIC GASTROENTEROLOGY - 10012 KENNERLY
Street 10012 KENNERLY RD, SUITE 102
City SAINT LOUIS
State MO
ZIP 63128
Phone 314 543-5911
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/31/2025
Certificate Expiration Date 5/30/2027
Facility Type Physician Office
Lab Director YAZAN ABDALLA

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