26D1087777 CLIA NUMBER - AIR EVAC 24

Laboratory Demographics

  • CLIA Code: 26D1087777
  • Facility Name: AIR EVAC 24
  • Facility Address: 3202 OAK GROVE ROAD
    POPLAR BLUFF, MO
    ZIP 63901
  • Facility Phone: 573 778-9077
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: BRANDON GRAHAM
  • NPI Number: 1073596888
  • Taxonomy: 3416A0800X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 26D1087777
LAB Type Ambulance
Facility Name AIR EVAC 24
Street 3202 OAK GROVE ROAD
City POPLAR BLUFF
State MO
ZIP 63901
Phone 573 778-9077
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/11/2024
Certificate Expiration Date 8/10/2026
Facility Type Ambulance
Lab Director BRANDON GRAHAM

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