26D2260762 CLIA NUMBER - MIDWEST MEDICAL PRACTITIONERS

Laboratory Demographics

  • CLIA Code: 26D2260762
  • Facility Name: MIDWEST MEDICAL PRACTITIONERS
  • Facility Address: 120 BOYD STREET
    DESOTO, MO
    ZIP 63020
  • Facility Phone: 636 282-0380
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DANISH ABDUL JABBAR
  • NPI Number: 1255709143
  • Taxonomy: 207R00000X - Internal Medicine

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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
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/23/2024
Certificate Expiration Date 5/22/2026
Facility Type Physician Office
Lab Director DANISH ABDUL JABBAR

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