26D2288938 CLIA NUMBER - SSM HEALTHCARE GROUP DEPT OF INTERNAL MEDICINE

Laboratory Demographics

  • CLIA Code: 26D2288938
  • Facility Name: SSM HEALTHCARE GROUP DEPT OF INTERNAL MEDICINE
  • Facility Address: 2315 DOUGHERTY FERRY RD STE 205A, 211
    SAINT LOUIS, MO
    ZIP 63122
  • Facility Phone: 314 617-2269
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RAVI P. NAYAK MD
  • NPI Number: 1063960409
  • Taxonomy: 332B00000X - Durable Medical Equipment & Medical Supplies

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CLIA Record

Field Name Field Value
CLIA Number 26D2288938
LAB Type Physician Office
Facility Name SSM HEALTHCARE GROUP DEPT OF INTERNAL MEDICINE
Street 2315 DOUGHERTY FERRY RD STE 205A, 211
City SAINT LOUIS
State MO
ZIP 63122
Phone 314 617-2269
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2025
Certificate Expiration Date 8/31/2027
Facility Type Physician Office
Lab Director RAVI P. NAYAK MD

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