14D0972264 CLIA NUMBER - S I H F BELLEVILLE FAMILY HEALTH CENTER

Laboratory Demographics

CLIA Number: 14D0972264

Facility Name: S I H F BELLEVILLE FAMILY HEALTH CENTER

Facility Address:
180 S 3RD ST, STE 104
BELLEVILLE, IL
ZIP 62220
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Facility Phone Number: 618 222-4701

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1780609578

Taxonomy: 261QF0400X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	14D0972264
LAB Type	Physician Office
Facility Name	S I H F BELLEVILLE FAMILY HEALTH CENTER
Street	180 S 3RD ST, STE 104
City	BELLEVILLE
State	IL
ZIP	62220
Phone	618 222-4701
CertificateType	3
CertificateEffectiveDate	4/3/2024
CertificateExpirationDate	4/2/2026
FacilityType	PPMP

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This page was last updated on: 4/23/2024