26D1084941 CLIA NUMBER - PROFESSIONAL IMAGING

Laboratory Demographics

  • CLIA Code: 26D1084941
  • Facility Name: PROFESSIONAL IMAGING
  • Facility Address: 1050 OLD DES PERES ROAD, SUITE 30
    ST. LOUIS, MO
    ZIP 63131
  • Facility Phone: 314 743-2000
  • Facility Type: Independent
  • Facility Type: Waiver
  • Lab Director: ALEXANDREA A. BLECKLER
  • NPI Number: 1619081940
  • Taxonomy: 261QR0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 26D1084941
LAB Type Independent
Facility Name PROFESSIONAL IMAGING
Street 1050 OLD DES PERES ROAD, SUITE 30
City ST. LOUIS
State MO
ZIP 63131
Phone 314 743-2000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/6/2024
Certificate Expiration Date 6/5/2026
Facility Type Independent
Lab Director ALEXANDREA A. BLECKLER

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