26D2302743 CLIA NUMBER - ST LOUIS MEDICAL CLINIC SOUTH

Laboratory Demographics

  • CLIA Code: 26D2302743
  • Facility Name: ST LOUIS MEDICAL CLINIC SOUTH
  • Facility Address: 1400 LEMAY FERRY RD
    SAINT LOUIS, MO
    ZIP 63125
  • Facility Phone: 314 983-4000
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: HASHIN S. RAZA
  • NPI Number: 1174505127
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 26D2302743
LAB Type Physician Office
Facility Name ST LOUIS MEDICAL CLINIC SOUTH
Street 1400 LEMAY FERRY RD
City SAINT LOUIS
State MO
ZIP 63125
Phone 314 983-4000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/16/2024
Certificate Expiration Date 4/15/2026
Facility Type Physician Office
Lab Director HASHIN S. RAZA

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This page was last updated on: 3/20/2025