14D0436720 CLIA NUMBER - MURPHYSBORO FAMILY MEDICINE CLINIC

Laboratory Demographics

  • CLIA Code: 14D0436720
  • Facility Name: MURPHYSBORO FAMILY MEDICINE CLINIC
  • Facility Address: 628 N 14TH
    MURPHYSBORO, IL
    ZIP 62966
  • Facility Phone: 618 687-2353
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: THOMAS W. KUPFERER
  • NPI Number: 1952369902
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D0436720
LAB Type Physician Office
Facility Name MURPHYSBORO FAMILY MEDICINE CLINIC
Street 628 N 14TH
City MURPHYSBORO
State IL
ZIP 62966
Phone 618 687-2353
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 7/6/2024
Certificate Expiration Date 7/5/2026
Facility Type Physician Office
Lab Director THOMAS W. KUPFERER

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