26D2210150 CLIA NUMBER - EVANGEL UNIVERSITY HEALTH SERVICES

Laboratory Demographics

CLIA Number: 26D2210150

Facility Name: EVANGEL UNIVERSITY HEALTH SERVICES

Facility Address:
1111 N GLENSTONE AVENUE CANTRELL STUDENT UNION, 106A
SPRINGFIELD, MO
ZIP 65802
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Facility Phone Number: 417 865-2815

Facility Type: School/Student Health Service

Certificate Type: Waiver

NPI Number: 1518310101

Taxonomy: 261Q00000X - Clinic/Center
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

CLIA Record

Field Name	Field Value
CLIA Number	26D2210150
LAB Type	School/Student Health Service
Facility Name	EVANGEL UNIVERSITY HEALTH SERVICES
Street	1111 N GLENSTONE AVENUE CANTRELL STUDENT UNION, 106A
City	SPRINGFIELD
State	MO
ZIP	65802
Phone	417 865-2815
CertificateType	4
CertificateEffectiveDate	1/20/2023
CertificateExpirationDate	1/19/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024