26D2270751 CLIA NUMBER - PHYSICIANS AMBULATORY SURGERY CENTER, LLC

Laboratory Demographics

  • CLIA Code: 26D2270751
  • Facility Name: PHYSICIANS AMBULATORY SURGERY CENTER, LLC
  • Facility Address: 114 PIPER HILL DR SUITE 101
    ST PETERS, MO
    ZIP 63376
  • Facility Phone: 636 706-0560
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: MICHAEL S. BOEDEFELD
  • NPI Number: 1285358481
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 26D2270751
LAB Type Ambulatory Surgery Center
Facility Name PHYSICIANS AMBULATORY SURGERY CENTER, LLC
Street 114 PIPER HILL DR SUITE 101
City ST PETERS
State MO
ZIP 63376
Phone 636 706-0560
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/20/2024
Certificate Expiration Date 10/19/2026
Facility Type Ambulatory Surgery Center
Lab Director MICHAEL S. BOEDEFELD

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