14D0908228 CLIA NUMBER - SSM HEALTH MONROE CLINIC - FREEPORT BRANCH

Laboratory Demographics

  • CLIA Code: 14D0908228
  • Facility Name: SSM HEALTH MONROE CLINIC - FREEPORT BRANCH
  • Facility Address: 1301 S KIWANIS DR
    FREEPORT, IL
    ZIP 61032
  • Facility Phone: 815 324-1047
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: AMY LECLAIR
  • NPI Number: 1831254036
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D0908228
LAB Type Physician Office
Facility Name SSM HEALTH MONROE CLINIC - FREEPORT BRANCH
Street 1301 S KIWANIS DR
City FREEPORT
State IL
ZIP 61032
Phone 815 324-1047
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/25/2024
Certificate Expiration Date 4/24/2026
Facility Type Physician Office
Lab Director AMY LECLAIR

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