26D2213798 CLIA NUMBER - GATEWAY DIRECT PRIMARYCARE JV LLC-FLORISSANT

Laboratory Demographics

  • CLIA Code: 26D2213798
  • Facility Name: GATEWAY DIRECT PRIMARYCARE JV LLC-FLORISSANT
  • Facility Address: 245 DUNN ROAD
    FLORISSANT, MO
    ZIP 63031
  • Facility Phone: 866 808-6005
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JESSICA SMITH
  • NPI Number: 1285228304
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 26D2213798
LAB Type Physician Office
Facility Name GATEWAY DIRECT PRIMARYCARE JV LLC-FLORISSANT
Street 245 DUNN ROAD
City FLORISSANT
State MO
ZIP 63031
Phone 866 808-6005
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/17/2025
Certificate Expiration Date 2/16/2027
Facility Type Physician Office
Lab Director JESSICA SMITH

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