26D1085163 CLIA NUMBER - INTEGRATIVE SPINE CARE LLC

Laboratory Demographics

  • CLIA Code: 26D1085163
  • Facility Name: INTEGRATIVE SPINE CARE LLC
  • Facility Address: 13710 OLIVE BLVD
    CHESTERFIELD, MO
    ZIP 63017
  • Facility Phone: 314 469-7246
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MANISH SUTHAR
  • NPI Number: 1649623240
  • Taxonomy: 261QP3300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 26D1085163
LAB Type Physician Office
Facility Name INTEGRATIVE SPINE CARE LLC
Street 13710 OLIVE BLVD
City CHESTERFIELD
State MO
ZIP 63017
Phone 314 469-7246
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/17/2024
Certificate Expiration Date 3/16/2026
Facility Type Physician Office
Lab Director MANISH SUTHAR

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