26D2300850 CLIA NUMBER - EVERSIDE HEALTH NEOSHO

Laboratory Demographics

CLIA Number: 26D2300850

Facility Name: EVERSIDE HEALTH NEOSHO

Facility Address:
4301 HOWARD BUSH DRIVE
NEOSHO, MO
ZIP 64850
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Facility Phone Number: 704 661-1380

Facility Type: Other - CHRONIC MGT

Certificate Type: Waiver

NPI Number: 1164292371

Taxonomy: 2083P0500X - Preventive Medicine
A preventive medicine physician who specializes in preventive medicine/occupational-environmental medicine, which is focused on protecting the population from occupational and environmental conditions.

CLIA Record

Field Name	Field Value
CLIA Number	26D2300850
LAB Type	Other - CHRONIC MGT
Facility Name	EVERSIDE HEALTH NEOSHO
Street	4301 HOWARD BUSH DRIVE
City	NEOSHO
State	MO
ZIP	64850
Phone	704 661-1380
CertificateType	4
CertificateEffectiveDate	3/18/2024
CertificateExpirationDate	3/17/2026
FacilityType	Waiver

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This page was last updated on: 4/23/2024