26D2083368 CLIA NUMBER - HOMETOWN FAMILY MEDICINE

Laboratory Demographics

  • CLIA Code: 26D2083368
  • Facility Name: HOMETOWN FAMILY MEDICINE
  • Facility Address: 4581 GRAVOIS ROAD
    HOUSE SPRINGS, MO
    ZIP 63051
  • Facility Phone: (636) 671-9980
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RENEE L. WILLER
  • NPI Number: 1255730446
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 26D2083368
LAB Type Physician Office
Facility Name HOMETOWN FAMILY MEDICINE
Street 4581 GRAVOIS ROAD
City HOUSE SPRINGS
State MO
ZIP 63051
Phone 6366719980
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/4/2024
Certificate Expiration Date 9/3/2026
Facility Type Physician Office
Lab Director RENEE L. WILLER

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This page was last updated on: 5/18/2026