26D2048143 CLIA NUMBER - PUTNAM COUNTY MEDICAL HOME CLINICS LLC

Laboratory Demographics

  • CLIA Code: 26D2048143
  • Facility Name: PUTNAM COUNTY MEDICAL HOME CLINICS LLC
  • Facility Address: 103 SOUTH 18TH
    UNIONVILLE, MO
    ZIP 63565
  • Facility Phone: 660 947-2300
  • Facility Type: Rural Health Clinic
  • Facility Type: Waiver
  • Lab Director: DAWN FAIRLEY
  • NPI Number: 1437600657
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 26D2048143
LAB Type Rural Health Clinic
Facility Name PUTNAM COUNTY MEDICAL HOME CLINICS LLC
Street 103 SOUTH 18TH
City UNIONVILLE
State MO
ZIP 63565
Phone 660 947-2300
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/10/2024
Certificate Expiration Date 10/9/2026
Facility Type Rural Health Clinic
Lab Director DAWN FAIRLEY

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