26D1096719 CLIA NUMBER - RIVERSIDE DERMATOLOGY

Laboratory Demographics

  • CLIA Code: 26D1096719
  • Facility Name: RIVERSIDE DERMATOLOGY
  • Facility Address: 163 MEDICAL DRIVE
    HANNIBAL, MO
    ZIP 63401
  • Facility Phone: 573 719-1818
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: LINDA M. COOKE
  • NPI Number: 1699262329
  • Taxonomy: 261QM1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 26D1096719
LAB Type Physician Office
Facility Name RIVERSIDE DERMATOLOGY
Street 163 MEDICAL DRIVE
City HANNIBAL
State MO
ZIP 63401
Phone 573 719-1818
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 1/13/2025
Certificate Expiration Date 1/12/2027
Facility Type Physician Office
Lab Director LINDA M. COOKE

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