26D2015372 CLIA NUMBER - MIDWEST ENT CENTRE

Laboratory Demographics

  • CLIA Code: 26D2015372
  • Facility Name: MIDWEST ENT CENTRE
  • Facility Address: 4790 EXECUTIVE CENTRE PARKWAY
    SAINT PETERS, MO
    ZIP 63376
  • Facility Phone: 636 441-3100
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ROBERT R. MACDONALD
  • NPI Number: 1932236650
  • Taxonomy: 207Y00000X - Otolaryngology

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CLIA Record

Field Name Field Value
CLIA Number 26D2015372
LAB Type Physician Office
Facility Name MIDWEST ENT CENTRE
Street 4790 EXECUTIVE CENTRE PARKWAY
City SAINT PETERS
State MO
ZIP 63376
Phone 636 441-3100
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/7/2024
Certificate Expiration Date 10/6/2026
Facility Type Physician Office
Lab Director ROBERT R. MACDONALD

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