26D2274273 CLIA NUMBER - COVENANT PEDIATRICS, LLC

Laboratory Demographics

  • CLIA Code: 26D2274273
  • Facility Name: COVENANT PEDIATRICS, LLC
  • Facility Address: 2409 HYDE PARK RD
    JEFFERSON CITY, MO
    ZIP 65109
  • Facility Phone: 573 635-6217
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SONIA L. MCGOWIN
  • NPI Number: 1942911607
  • Taxonomy: 261QH0100X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 26D2274273
LAB Type Physician Office
Facility Name COVENANT PEDIATRICS, LLC
Street 2409 HYDE PARK RD
City JEFFERSON CITY
State MO
ZIP 65109
Phone 573 635-6217
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/30/2024
Certificate Expiration Date 12/29/2026
Facility Type Physician Office
Lab Director SONIA L. MCGOWIN

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