14D0666837 CLIA NUMBER - HEARTLAND SURGERY L L C

Laboratory Demographics

  • CLIA Code: 14D0666837
  • Facility Name: HEARTLAND SURGERY L L C
  • Facility Address: 3402 OFFICE PARK DRIVE
    MARION, IL
    ZIP 62959
  • Facility Phone: 618 993-3221
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CLAY O. DEMATTEI, M D
  • NPI Number: 1336172766
  • Taxonomy: 208600000X - Surgery

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CLIA Record

Field Name Field Value
CLIA Number 14D0666837
LAB Type Physician Office
Facility Name HEARTLAND SURGERY L L C
Street 3402 OFFICE PARK DRIVE
City MARION
State IL
ZIP 62959
Phone 618 993-3221
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director CLAY O. DEMATTEI, M D

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