26D2081535 CLIA NUMBER - PREMIER DENTAL PARTNERS

Laboratory Demographics

  • CLIA Code: 26D2081535
  • Facility Name: PREMIER DENTAL PARTNERS
  • Facility Address: 605 OLD BALLAS RD, SUITE 130
    SAINT LOUIS, MO
    ZIP 63141
  • Facility Phone: 314 210-1238
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: COLLIN M. STUTZ
  • NPI Number: 1699169086
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 26D2081535
LAB Type Practitioner Other
Facility Name PREMIER DENTAL PARTNERS
Street 605 OLD BALLAS RD, SUITE 130
City SAINT LOUIS
State MO
ZIP 63141
Phone 314 210-1238
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/28/2024
Certificate Expiration Date 7/27/2026
Facility Type Practitioner Other
Lab Director COLLIN M. STUTZ

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