26D2050350 CLIA NUMBER - MIDWEST SURGERY CENTER, LLC

Laboratory Demographics

  • CLIA Code: 26D2050350
  • Facility Name: MIDWEST SURGERY CENTER, LLC
  • Facility Address: 65 DOCTORS PARK DRIVE, SUITE B
    CAPE GIRARDEAU, MO
    ZIP 63703
  • Facility Phone: 573 803-2420
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: SONJAY J. FONN
  • NPI Number: 1003171745
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 26D2050350
LAB Type Ambulatory Surgery Center
Facility Name MIDWEST SURGERY CENTER, LLC
Street 65 DOCTORS PARK DRIVE, SUITE B
City CAPE GIRARDEAU
State MO
ZIP 63703
Phone 573 803-2420
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/29/2025
Certificate Expiration Date 8/28/2027
Facility Type Ambulatory Surgery Center
Lab Director SONJAY J. FONN

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