26D1105228 CLIA NUMBER - WESTERN MISSOURI FAMILY HEALTHCARE-CONCORDIA

Laboratory Demographics

CLIA Number: 26D1105228

Facility Name: WESTERN MISSOURI FAMILY HEALTHCARE-CONCORDIA

Facility Address:
905 S MAIN STREET 64020
CONCORDIA, MO
ZIP 64020
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Facility Phone Number: 660 463-7966

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1215388293

Taxonomy: 261QR1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	26D1105228
LAB Type	Physician Office
Facility Name	WESTERN MISSOURI FAMILY HEALTHCARE-CONCORDIA
Street	905 S MAIN STREET 64020
City	CONCORDIA
State	MO
ZIP	64020
Phone	660 463-7966
CertificateType	3
CertificateEffectiveDate	7/16/2022
CertificateExpirationDate	7/15/2024
FacilityType	PPMP

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This page was last updated on: 4/23/2024