14D0963466 CLIA NUMBER - MIDWEST OB/GYN INFERTILITY CENTER

Laboratory Demographics

  • CLIA Code: 14D0963466
  • Facility Name: MIDWEST OB/GYN INFERTILITY CENTER
  • Facility Address: 675 E SNYDER DR, STE 1
    DECATUR, IL
    ZIP 62526
  • Facility Phone: 217 875-1886
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: VIDYA SAGAR RAO MORISETTY
  • NPI Number: 1104173533
  • Taxonomy: 207V00000X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 14D0963466
LAB Type Physician Office
Facility Name MIDWEST OB/GYN INFERTILITY CENTER
Street 675 E SNYDER DR, STE 1
City DECATUR
State IL
ZIP 62526
Phone 217 875-1886
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 7/30/2025
Certificate Expiration Date 7/29/2027
Facility Type Physician Office
Lab Director VIDYA SAGAR RAO MORISETTY

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