Healthcare Provider Details

I. General information

NPI: 1225963085
Provider Name (Legal Business Name): QUALITY CLINICAL LABORATORIES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 MARKET ST STE 301C
FULTON MO
65251-2804
US

IV. Provider business mailing address

500 MARKET ST STE 301C
FULTON MO
65251-2804
US

V. Phone/Fax

Practice location:
  • Phone: 844-572-3406
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: KARLA KELLY
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 844-572-3406