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RENOVA MEDICAL CENTER, LLC
NPI 1447741681
General Practice in Columbia, MO

Active since May 23, 2018CLIA 26D2271889 · Waiver
1401 FORUM BLVD STE 101, COLUMBIA, MO 65203(573) 228-0217(573) 234-1368 Get Directions Write a Review

NPPES record last updated: May 23, 2018. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Renova Medical Center, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RENOVA MEDICAL CENTER, LLC (NPI 1447741681) is a healthcare organization registered as a general practice in Columbia, Missouri and active in the NPI registry since May 2018. The organization holds a CLIA Waiver certificate valid through November 8, 2026 and lists Kerrie J Rose, Owner, as its authorized official.

NPPES Registry Identity

NPI1447741681
Entity TypeOrganization
Primary Taxonomy208D00000X
Legal Business NameRENOVA MEDICAL CENTER, LLC
Location Address1401 FORUM BLVD STE 101Columbia, MO 65203-1915
Mailing Address1401 Forum Blvd Ste 101Columbia, MO 65203-1915 · (573) 228-0217 · Fax (573) 234-1368
Phone(573) 228-0217
Fax(573) 234-1368
Organization SubpartNo
Authorized OfficialKerrie J RoseOwner · (573) 228-0217
Enumeration DateMay 23, 2018
✔ NPI 1447741681 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
1401 FORUM BLVD STE 101, Columbia, MO 65203
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 26D2271889

Renova Medical Center, LLC · Columbia, MO
Active · expires Nov 8, 2026
CLIA Number26D2271889
Laboratory TypePhysician Office
Certificate Effective DateNovember 9, 2024
Certificate Expiration DateNovember 8, 2026
Laboratory DirectorRobert Calaluce
Laboratory Phone(573) 234-1367
Laboratory LocationRenova Medical Center, LLC1401 Forum Blvd, Suite 202, Columbia, MO 65203
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. AARON C ROSE D.C.
Chiropractor
1401 FORUM BLVD STE 101
COLUMBIA, MO 65203
Boone County (573) 228-0219
ROSE FAMILY CHIROPRACTIC LLC
Chiropractor
1401 FORUM BLVD STE 101
COLUMBIA, MO 65203
Boone County (573) 234-1367

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Renova Medical Center, LLC's NPI number?

The NPI number for Renova Medical Center, LLC is 1447741681. It was assigned to this organization in the NPPES registry on May 23, 2018.

Where is Renova Medical Center, LLC located?

Renova Medical Center, LLC is located at 1401 Forum Blvd Ste 101, Columbia, MO 65203. The listed phone number is (573) 228-0217.

What is Renova Medical Center, LLC's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Does Renova Medical Center, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 26D2271889) is associated with this NPI, valid through November 8, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Renova Medical Center, LLC was last updated on May 23, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.