14D0962052 CLIA NUMBER - ANDERSON HOSPITAL

Laboratory Demographics

  • CLIA Code: 14D0962052
  • Facility Name: ANDERSON HOSPITAL
  • Facility Address: 6800 STATE ROUTE 162
    MARYVILLE, IL
    ZIP 62062
  • Facility Phone: 618 391-6752
  • Facility Type: Hospital
  • Facility Type: Waiver
  • Lab Director: FREDERICK S. WREFORD
  • NPI Number: 1619519535
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D0962052
LAB Type Hospital
Facility Name ANDERSON HOSPITAL
Street 6800 STATE ROUTE 162
City MARYVILLE
State IL
ZIP 62062
Phone 618 391-6752
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/23/2025
Certificate Expiration Date 6/22/2027
Facility Type Hospital
Lab Director FREDERICK S. WREFORD

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