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26D2260762 CLIA NUMBER - MIDWEST MEDICAL PRACTITIONERS

Laboratory Demographics

CLIA Number: 26D2260762

Facility Name: MIDWEST MEDICAL PRACTITIONERS

Facility Address:
120 BOYD STREET
DESOTO, MO
ZIP 63020
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Facility Phone Number: 636 282-0380

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1255709143

Taxonomy: 207R00000X - Internal Medicine
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

CLIA Record

Field Name Field Value
CLIA Number 26D2260762
LAB Type Physician Office
Facility Name MIDWEST MEDICAL PRACTITIONERS
Street 120 BOYD STREET
City DESOTO
State MO
ZIP 63020
Phone 636 282-0380
CertificateType 4
CertificateEffectiveDate 5/23/2022
CertificateExpirationDate 5/22/2024
FacilityType Waiver

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