26D1100532 CLIA NUMBER - CAPE RADIOLOGY GROUP

Laboratory Demographics

  • CLIA Code: 26D1100532
  • Facility Name: CAPE RADIOLOGY GROUP
  • Facility Address: 70 DOCTORS PARK
    CAPE GIRARDEAU, MO
    ZIP 63703
  • Facility Phone: 573 334-6071
  • Facility Type: Other
  • Facility Type: Waiver
  • Lab Director: SIMSOUDA MAHATHATH
  • NPI Number: 1598708331
  • Taxonomy: 2085R0202X - Radiology

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CLIA Record

Field Name Field Value
CLIA Number 26D1100532
LAB Type Other
Facility Name CAPE RADIOLOGY GROUP
Street 70 DOCTORS PARK
City CAPE GIRARDEAU
State MO
ZIP 63703
Phone 573 334-6071
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/8/2025
Certificate Expiration Date 6/7/2027
Facility Type Other
Lab Director SIMSOUDA MAHATHATH

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