26D2309301 CLIA NUMBER - HEALTHSPAN DIRECT PRIMARY CARE LLC

Laboratory Demographics

  • CLIA Code: 26D2309301
  • Facility Name: HEALTHSPAN DIRECT PRIMARY CARE LLC
  • Facility Address: 1000 CENTRAL ST
    LA BELLE, MO
    ZIP 63447
  • Facility Phone: 660 341-7645
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: AARON NEISEN
  • NPI Number: 1962299495
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 26D2309301
LAB Type Practitioner Other
Facility Name HEALTHSPAN DIRECT PRIMARY CARE LLC
Street 1000 CENTRAL ST
City LA BELLE
State MO
ZIP 63447
Phone 660 341-7645
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/13/2024
Certificate Expiration Date 8/12/2026
Facility Type Practitioner Other
Lab Director AARON NEISEN

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