14D0950292 CLIA NUMBER - QUAD CITY AMBULATORY SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 14D0950292
  • Facility Name: QUAD CITY AMBULATORY SURGERY CENTER
  • Facility Address: 520 VALLEY VIEW DRIVE SUITE 300
    MOLINE, IL
    ZIP 61265
  • Facility Phone: 309 672-1952
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: THOMAS L. VONGILLERN
  • NPI Number: 1194058123
  • Taxonomy: 335E00000X - Prosthetic/Orthotic Supplier

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CLIA Record

Field Name Field Value
CLIA Number 14D0950292
LAB Type Ambulatory Surgery Center
Facility Name QUAD CITY AMBULATORY SURGERY CENTER
Street 520 VALLEY VIEW DRIVE SUITE 300
City MOLINE
State IL
ZIP 61265
Phone 309 672-1952
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/21/2024
Certificate Expiration Date 8/20/2026
Facility Type Ambulatory Surgery Center
Lab Director THOMAS L. VONGILLERN

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