26D2244255 CLIA NUMBER - THOMAS CARE CLINIC LLC

Laboratory Demographics

CLIA Number: 26D2244255

Facility Name: THOMAS CARE CLINIC LLC

Facility Address:
2040 E SUNSHINE ST
SPRINGFIELD, MO
ZIP 65804
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Facility Phone Number: 417 275-8900

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1962086496

Taxonomy: 261QH0100X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	26D2244255
LAB Type	Physician Office
Facility Name	THOMAS CARE CLINIC LLC
Street	2040 E SUNSHINE ST
City	SPRINGFIELD
State	MO
ZIP	65804
Phone	417 275-8900
CertificateType	4
CertificateEffectiveDate	11/30/2023
CertificateExpirationDate	11/29/2025
FacilityType	Waiver

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