14D0961477 CLIA NUMBER - GENESIS HEALTH GROUP GENESIS HEALTH SYSTEM

Laboratory Demographics

  • CLIA Code: 14D0961477
  • Facility Name: GENESIS HEALTH GROUP GENESIS HEALTH SYSTEM
  • Facility Address: 3900 28TH AVENUE DR, STE 200
    MOLINE, IL
    ZIP 61265
  • Facility Phone: 309 792-6540
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: BRIAN D. ANDERSON
  • NPI Number: 1114021532
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D0961477
LAB Type Physician Office
Facility Name GENESIS HEALTH GROUP GENESIS HEALTH SYSTEM
Street 3900 28TH AVENUE DR, STE 200
City MOLINE
State IL
ZIP 61265
Phone 309 792-6540
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 6/8/2025
Certificate Expiration Date 6/7/2027
Facility Type Physician Office
Lab Director BRIAN D. ANDERSON

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