14D0646785 CLIA NUMBER - OSF GALESBURG CLINIC LAB/ANCILLARY

Laboratory Demographics

  • CLIA Code: 14D0646785
  • Facility Name: OSF GALESBURG CLINIC LAB/ANCILLARY
  • Facility Address: 3315 N SEMINARY ST
    GALESBURG, IL
    ZIP 61401
  • Facility Phone: 309 344-1000
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: VLADIMIR STRUNIN
  • NPI Number: 1225346349
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D0646785
LAB Type Physician Office
Facility Name OSF GALESBURG CLINIC LAB/ANCILLARY
Street 3315 N SEMINARY ST
City GALESBURG
State IL
ZIP 61401
Phone 309 344-1000
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 11/6/2023
Certificate Expiration Date 11/5/2025
Facility Type Physician Office
Lab Director VLADIMIR STRUNIN

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