26D2139419 CLIA NUMBER - EBOMD, LLC

Laboratory Demographics

  • CLIA Code: 26D2139419
  • Facility Name: EBOMD, LLC
  • Facility Address: 1417 NORTH MOUNT AUBURN
    CAPE GIRARDEAU, MO
    ZIP 63701
  • Facility Phone: 573 803-2941
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: TONY THOMPSON
  • NPI Number: 1326503376
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 26D2139419
LAB Type Physician Office
Facility Name EBOMD, LLC
Street 1417 NORTH MOUNT AUBURN
City CAPE GIRARDEAU
State MO
ZIP 63701
Phone 573 803-2941
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/3/2023
Certificate Expiration Date 11/2/2025
Facility Type Physician Office
Lab Director TONY THOMPSON

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This page was last updated on: 6/4/2025