14D0712106 CLIA NUMBER - HSHSMG UROLOGY - EFFINGHAM

Laboratory Demographics

  • CLIA Code: 14D0712106
  • Facility Name: HSHSMG UROLOGY - EFFINGHAM
  • Facility Address: 414 W VIRGINIA AVE
    EFFINGHAM, IL
    ZIP 62401
  • Facility Phone: 217 342-9738
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: P DHARMADEV NAYAK
  • NPI Number: 1902911431
  • Taxonomy: 261QH0100X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D0712106
LAB Type Physician Office
Facility Name HSHSMG UROLOGY - EFFINGHAM
Street 414 W VIRGINIA AVE
City EFFINGHAM
State IL
ZIP 62401
Phone 217 342-9738
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/6/2024
Certificate Expiration Date 9/5/2026
Facility Type Physician Office
Lab Director P DHARMADEV NAYAK

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