26D2315656 CLIA NUMBER - GUARDIAN PRIMARY CARE, LLC

Laboratory Demographics

  • CLIA Code: 26D2315656
  • Facility Name: GUARDIAN PRIMARY CARE, LLC
  • Facility Address: 1420 KURRE LN
    JACKSON, MO
    ZIP 63755
  • Facility Phone: 573 200-6390
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: PRESTON T. HOLIFIELD
  • NPI Number: 1568286110
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 26D2315656
LAB Type Practitioner Other
Facility Name GUARDIAN PRIMARY CARE, LLC
Street 1420 KURRE LN
City JACKSON
State MO
ZIP 63755
Phone 573 200-6390
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/17/2024
Certificate Expiration Date 12/16/2026
Facility Type Practitioner Other
Lab Director PRESTON T. HOLIFIELD

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