26D2327671 CLIA NUMBER - CARUTHERSVILLE MEDICAL CLINIC

Laboratory Demographics

  • CLIA Code: 26D2327671
  • Facility Name: CARUTHERSVILLE MEDICAL CLINIC
  • Facility Address: 106 WEST 12TH STREET
    CARUTHERSVILLE, MO
    ZIP 63830
  • Facility Phone: 573 575-4181
  • Facility Type: Rural Health Clinic
  • Facility Type: Waiver
  • Lab Director: DOUGLAS S. FITZWATER
  • NPI Number: 1487829222
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 26D2327671
LAB Type Rural Health Clinic
Facility Name CARUTHERSVILLE MEDICAL CLINIC
Street 106 WEST 12TH STREET
City CARUTHERSVILLE
State MO
ZIP 63830
Phone 573 575-4181
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/28/2025
Certificate Expiration Date 7/27/2027
Facility Type Rural Health Clinic
Lab Director DOUGLAS S. FITZWATER

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