14D0433433 CLIA NUMBER - BARD AND DIDRIKSEN PEDIATRICS

Laboratory Demographics

  • CLIA Code: 14D0433433
  • Facility Name: BARD AND DIDRIKSEN PEDIATRICS
  • Facility Address: 2160 SO ILLINOIS RT 157, SUITE B
    GLEN CARBON, IL
    ZIP 62034
  • Facility Phone: 618 692-1212
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: LIZBETH H. DIDRIKSEN
  • NPI Number: 1669553186
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 14D0433433
LAB Type Physician Office
Facility Name BARD AND DIDRIKSEN PEDIATRICS
Street 2160 SO ILLINOIS RT 157, SUITE B
City GLEN CARBON
State IL
ZIP 62034
Phone 618 692-1212
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/27/2024
Certificate Expiration Date 12/26/2026
Facility Type Physician Office
Lab Director LIZBETH H. DIDRIKSEN

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