26D2006074 CLIA NUMBER - TCMH MOUNTAIN GROVE CLINIC

Home > CLIA Lookup > 26D2006074

Laboratory Demographics

CLIA Number: 26D2006074

Facility Name: TCMH MOUNTAIN GROVE CLINIC

Facility Address:
1905 WEST 19TH STREET
MOUNTAIN GROVE, MO
ZIP 65711
Get Directions

Facility Phone Number: 417 926-1770

Facility Type: Rural Health Clinic

Certificate Type: Microscopy

NPI Number: 1265754501

Taxonomy: 261QR1300X - Clinic/Center

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
CertificateType	3
CertificateEffectiveDate	4/12/2024
CertificateExpirationDate	4/11/2026
FacilityType	PPMP

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

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