26D1104207 CLIA NUMBER - O'FALLON MISSOURI DIALYSIS

Laboratory Demographics

  • CLIA Code: 26D1104207
  • Facility Name: O'FALLON MISSOURI DIALYSIS
  • Facility Address: 4663 HIGHWAY K
    O FALLON, MO
    ZIP 63368
  • Facility Phone: 636 329-0697
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: HENRIKAS JUKNIS
  • NPI Number: 1386879898
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 26D1104207
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name O'FALLON MISSOURI DIALYSIS
Street 4663 HIGHWAY K
City O FALLON
State MO
ZIP 63368
Phone 636 329-0697
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/27/2025
Certificate Expiration Date 8/26/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director HENRIKAS JUKNIS

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