26D2069770 CLIA NUMBER - MISSOURI CONSOLIDATED HEALTH CARE PLAN

Laboratory Demographics

  • CLIA Code: 26D2069770
  • Facility Name: MISSOURI CONSOLIDATED HEALTH CARE PLAN
  • Facility Address: 301 WEST HIGH STREET, ROOM 478
    JEFFERSON CITY, MO
    ZIP 65102
  • Facility Phone: 573 526-3175
  • Facility Type: Ancillary Testing Site in Health Care Center
  • Facility Type: Waiver
  • Lab Director: DANIEL GIBSON
  • NPI Number: 1518177591
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 26D2069770
LAB Type Ancillary Testing Site in Health Care Center
Facility Name MISSOURI CONSOLIDATED HEALTH CARE PLAN
Street 301 WEST HIGH STREET, ROOM 478
City JEFFERSON CITY
State MO
ZIP 65102
Phone 573 526-3175
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/3/2023
Certificate Expiration Date 12/2/2025
Facility Type Ancillary Testing Site in Health Care Center
Lab Director DANIEL GIBSON

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