26D2006074 CLIA NUMBER - TCMH MOUNTAIN GROVE CLINIC

Laboratory Demographics

  • CLIA Code: 26D2006074
  • Facility Name: TCMH MOUNTAIN GROVE CLINIC
  • Facility Address: 1905 WEST 19TH STREET
    MOUNTAIN GROVE, MO
    ZIP 65711
  • Facility Phone: 417 926-1770
  • Facility Type: Rural Health Clinic
  • Facility Type: Microscopy
  • Lab Director: ELTON W. HOERNING
  • NPI Number: 1265754501
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 26D2006074
LAB Type Rural Health Clinic
Facility Name TCMH MOUNTAIN GROVE CLINIC
Street 1905 WEST 19TH STREET
City MOUNTAIN GROVE
State MO
ZIP 65711
Phone 417 926-1770
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 4/12/2024
Certificate Expiration Date 4/11/2026
Facility Type Rural Health Clinic
Lab Director ELTON W. HOERNING

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