26D1074657 CLIA NUMBER - PHYSICIAN SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 26D1074657
  • Facility Name: PHYSICIAN SURGERY CENTER
  • Facility Address: 170 MEDICAL DRIVE
    HANNIBAL, MO
    ZIP 63401
  • Facility Phone: 573 231-0175
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: JOSEPH L. GIRA
  • NPI Number: 1811028293
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 26D1074657
LAB Type Ambulatory Surgery Center
Facility Name PHYSICIAN SURGERY CENTER
Street 170 MEDICAL DRIVE
City HANNIBAL
State MO
ZIP 63401
Phone 573 231-0175
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/3/2025
Certificate Expiration Date 10/2/2027
Facility Type Ambulatory Surgery Center
Lab Director JOSEPH L. GIRA

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