26D2190789 CLIA NUMBER - CHILDREN'S DENTAL ZONE

Laboratory Demographics

  • CLIA Code: 26D2190789
  • Facility Name: CHILDREN'S DENTAL ZONE
  • Facility Address: 13410 NEW HALLS FERRY ROAD
    FLORISSANT, MO
    ZIP 63033
  • Facility Phone: 314 830-9663
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CANDACE T. WAKEFIELD
  • NPI Number: 1700172806
  • Taxonomy: 261QD0000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 26D2190789
LAB Type Physician Office
Facility Name CHILDREN'S DENTAL ZONE
Street 13410 NEW HALLS FERRY ROAD
City FLORISSANT
State MO
ZIP 63033
Phone 314 830-9663
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/19/2024
Certificate Expiration Date 8/18/2026
Facility Type Physician Office
Lab Director CANDACE T. WAKEFIELD

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