26D2313859 CLIA NUMBER - CENTERWELL SENIOR PRIMARY CARE (MO), PC-GLADSTONE

Laboratory Demographics

  • CLIA Code: 26D2313859
  • Facility Name: CENTERWELL SENIOR PRIMARY CARE (MO), PC-GLADSTONE
  • Facility Address: 7209 N PROSPECT AVE
    GLADSTONE, MO
    ZIP 64119
  • Facility Phone: 816 429-1396
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RONDA WARREN
  • NPI Number: 1154148435
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 26D2313859
LAB Type Physician Office
Facility Name CENTERWELL SENIOR PRIMARY CARE (MO), PC-GLADSTONE
Street 7209 N PROSPECT AVE
City GLADSTONE
State MO
ZIP 64119
Phone 816 429-1396
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/7/2024
Certificate Expiration Date 11/6/2026
Facility Type Physician Office
Lab Director RONDA WARREN

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