26D2271960 CLIA NUMBER - JOPLIN PRIMARY CARE CLINIC ON JACKSONL SUITE 201

Laboratory Demographics

  • CLIA Code: 26D2271960
  • Facility Name: JOPLIN PRIMARY CARE CLINIC ON JACKSONL SUITE 201
  • Facility Address: 3126 S JACKSON AVE, STE 201
    JOPLIN, MO
    ZIP 64804
  • Facility Phone: 417 556-3802
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: AMANDA ANDRADE
  • NPI Number: 1326379710
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 26D2271960
LAB Type Physician Office
Facility Name JOPLIN PRIMARY CARE CLINIC ON JACKSONL SUITE 201
Street 3126 S JACKSON AVE, STE 201
City JOPLIN
State MO
ZIP 64804
Phone 417 556-3802
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/11/2024
Certificate Expiration Date 11/10/2026
Facility Type Physician Office
Lab Director AMANDA ANDRADE

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