26D2184760 CLIA NUMBER - EZELL CHIROPRACTIC

Laboratory Demographics

  • CLIA Code: 26D2184760
  • Facility Name: EZELL CHIROPRACTIC
  • Facility Address: 2201 1ST CAPITOL DRIVE
    ST CHARLES, MO
    ZIP 63301
  • Facility Phone: 636 485-6661
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: GLENN R. EZELL
  • NPI Number: 1982035440
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 26D2184760
LAB Type Practitioner Other
Facility Name EZELL CHIROPRACTIC
Street 2201 1ST CAPITOL DRIVE
City ST CHARLES
State MO
ZIP 63301
Phone 636 485-6661
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/26/2024
Certificate Expiration Date 5/25/2026
Facility Type Practitioner Other
Lab Director GLENN R. EZELL

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