26D1081202 CLIA NUMBER - PHOENIX HOME CARE

Laboratory Demographics

  • CLIA Code: 26D1081202
  • Facility Name: PHOENIX HOME CARE
  • Facility Address: 500 BROADWAY
    JEFFERSON CITY, MO
    ZIP 65101
  • Facility Phone: 573 635-3900
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: KATIE IRWIN
  • NPI Number: 1366888059
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 26D1081202
LAB Type Home Health Agency
Facility Name PHOENIX HOME CARE
Street 500 BROADWAY
City JEFFERSON CITY
State MO
ZIP 65101
Phone 573 635-3900
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/12/2024
Certificate Expiration Date 3/11/2026
Facility Type Home Health Agency
Lab Director KATIE IRWIN

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