14D0979884 CLIA NUMBER - CHERYL EMMONS MD SC

Laboratory Demographics

  • CLIA Code: 14D0979884
  • Facility Name: CHERYL EMMONS MD SC
  • Facility Address: 1100 S 42ND ST, STE B
    MOUNT VERNON, IL
    ZIP 62864
  • Facility Phone: 618 244-5053
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CHERYL EMMONS MD
  • NPI Number: 1295755114
  • Taxonomy: 207RN0300X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D0979884
LAB Type Physician Office
Facility Name CHERYL EMMONS MD SC
Street 1100 S 42ND ST, STE B
City MOUNT VERNON
State IL
ZIP 62864
Phone 618 244-5053
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/3/2024
Certificate Expiration Date 11/2/2026
Facility Type Physician Office
Lab Director CHERYL EMMONS MD

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