14D0433871 CLIA NUMBER - EAST SIDE HEALTH DISTRICT

Laboratory Demographics

  • CLIA Code: 14D0433871
  • Facility Name: EAST SIDE HEALTH DISTRICT
  • Facility Address: 638 NORTH 20TH STREET
    EAST SAINT LOUIS, IL
    ZIP 62205
  • Facility Phone: 618 874-4713
  • Facility Type: Other
  • Facility Type: Microscopy
  • Lab Director: THEODORE ROSS MD
  • NPI Number: 1245443464
  • Taxonomy: 251K00000X - Public Health or Welfare

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CLIA Record

Field Name Field Value
CLIA Number 14D0433871
LAB Type Other
Facility Name EAST SIDE HEALTH DISTRICT
Street 638 NORTH 20TH STREET
City EAST SAINT LOUIS
State IL
ZIP 62205
Phone 618 874-4713
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 7/10/2025
Certificate Expiration Date 7/9/2027
Facility Type Other
Lab Director THEODORE ROSS MD

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