26D1103242 CLIA NUMBER - THREE RIVERS HOSPICE, WEST

Laboratory Demographics

  • CLIA Code: 26D1103242
  • Facility Name: THREE RIVERS HOSPICE, WEST
  • Facility Address: 631 N SPRING PARK BLVD
    MOUNT VERNON, MO
    ZIP 65712
  • Facility Phone: 417 461-0580
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: DONNA BEAN
  • NPI Number: 1912174327
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 26D1103242
LAB Type Hospice
Facility Name THREE RIVERS HOSPICE, WEST
Street 631 N SPRING PARK BLVD
City MOUNT VERNON
State MO
ZIP 65712
Phone 417 461-0580
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/5/2023
Certificate Expiration Date 8/4/2025
Facility Type Hospice
Lab Director DONNA BEAN

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This page was last updated on: 3/20/2025