26D2079449 CLIA NUMBER - EAST CENTRAL MISSOURI BEHAVIORAL HEALTH SERVICES INC

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Laboratory Demographics

CLIA Number: 26D2079449

Facility Name: EAST CENTRAL MISSOURI BEHAVIORAL HEALTH SERVICES INC

Facility Address:
340 KELLEY PARKWAY
MEXICO, MO
ZIP 65265
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Facility Phone Number: 573 582-1234

Facility Type: Federally Qualified Health Center

Certificate Type: Waiver

NPI Number: 1174008023

Taxonomy: 261QF0400X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	26D2079449
LAB Type	Federally Qualified Health Center
Facility Name	EAST CENTRAL MISSOURI BEHAVIORAL HEALTH SERVICES INC
Street	340 KELLEY PARKWAY
City	MEXICO
State	MO
ZIP	65265
Phone	573 582-1234
CertificateType	4
CertificateEffectiveDate	6/17/2022
CertificateExpirationDate	6/16/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024