26D1103031 CLIA NUMBER - JEFFERSON COUNTY INTERNAL MEDICINE, PC

Laboratory Demographics

  • CLIA Code: 26D1103031
  • Facility Name: JEFFERSON COUNTY INTERNAL MEDICINE, PC
  • Facility Address: 1455 US HWY 61 SOUTH, STE B
    FESTUS, MO
    ZIP 63028
  • Facility Phone: 636 937-1528
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ASHUTOSH H. PATEL
  • NPI Number: 1851509855
  • Taxonomy: 261QM2500X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 26D1103031
LAB Type Physician Office
Facility Name JEFFERSON COUNTY INTERNAL MEDICINE, PC
Street 1455 US HWY 61 SOUTH, STE B
City FESTUS
State MO
ZIP 63028
Phone 636 937-1528
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/14/2024
Certificate Expiration Date 2/13/2026
Facility Type Physician Office
Lab Director ASHUTOSH H. PATEL

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