OTTO BEAN MEDICAL CENTER
NPI 1710108766
Clinic/Center - Federally Qualified Health Center (FQHC) in Kennett, MO
About Otto Bean Medical Center NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
OTTO BEAN MEDICAL CENTER (NPI 1710108766) is a healthcare organization registered as a federally qualified health center (fqhc) in Kennett, Missouri and active in the NPI registry since May 2007. The organization holds a CLIA Waiver certificate valid through September 25, 2027 and lists Sara Deane, Chief Financial Officer, as its authorized official.Information from the official NPPES registry record, last updated April 14, 2020.
NPPES Registry Identity
★ Primary Specialty
Also on File with NPPES
Otto Bean Medical Clinic (Other Name)
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 26D0924445
- Facility Type
- Physician Office
- Certificate Effective Date
- September 26, 2025
- Certificate Expiration Date
- September 25, 2027
- Laboratory Director
- DANIEL DOMJAN
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Otto Bean Medical Center to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
Reviews for OTTO BEAN MEDICAL CENTER
There are currently no reviews for this provider. Be the first person to share your experience with this provider by filling out our review form. Your insights are appreciated and will help others make informed decisions.
Other Providers at the Same Location
The following 6 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1710108766, enumerated as an "organization" on May 01, 2007.
The provider is located at 500 RUSSELL ST KENNETT, MO 63857 and the phone number is (573) 717-1332.
Clinic/Center with taxonomy code 261QF0400X and a focus in Federally Qualified Health Center (FQHC).
The provider might be accepting Accepts: Ambetter from Arkansas Health & Wellness, Ambetter. Please consult your insurance carrier or call the provider to verify.
