14D0932715 CLIA NUMBER - JAMES J DALLA RIVA MD PC

Laboratory Demographics

  • CLIA Code: 14D0932715
  • Facility Name: JAMES J DALLA RIVA MD PC
  • Facility Address: 6810 STATE ROUTE 162 SUITE 301
    MARYVILLE, IL
    ZIP 62062
  • Facility Phone: 618 288-5699
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: JAMES J. DALLA RIVA MD
  • NPI Number: 1215040415
  • Taxonomy: 207V00000X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 14D0932715
LAB Type Physician Office
Facility Name JAMES J DALLA RIVA MD PC
Street 6810 STATE ROUTE 162 SUITE 301
City MARYVILLE
State IL
ZIP 62062
Phone 618 288-5699
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 8/26/2025
Certificate Expiration Date 8/25/2027
Facility Type Physician Office
Lab Director JAMES J. DALLA RIVA MD

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