26D2072865 CLIA NUMBER - LACLEDE GROVES

Laboratory Demographics

  • CLIA Code: 26D2072865
  • Facility Name: LACLEDE GROVES
  • Facility Address: 723 SOUTH LACLEDE STATION ROAD
    SAINT LOUIS, MO
    ZIP 63119
  • Facility Phone: 314 968-5570
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: VALERIA COOPER
  • NPI Number: 1457924755
  • Taxonomy: 164W00000X - Licensed Practical Nurse

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CLIA Record

Field Name Field Value
CLIA Number 26D2072865
LAB Type Community Clinic
Facility Name LACLEDE GROVES
Street 723 SOUTH LACLEDE STATION ROAD
City SAINT LOUIS
State MO
ZIP 63119
Phone 314 968-5570
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/2/2024
Certificate Expiration Date 5/1/2026
Facility Type Community Clinic
Lab Director VALERIA COOPER

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