14D0984681 CLIA NUMBER - SIU PHYSICIANS & SURGEONS INC

Laboratory Demographics

  • CLIA Code: 14D0984681
  • Facility Name: SIU PHYSICIANS & SURGEONS INC
  • Facility Address: 747 N RUTLEDGE - BAYLIS - FLOOR 5
    SPRINGFIELD, IL
    ZIP 62702
  • Facility Phone: 217 545-8000
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: BRADLEY F. SCHWARTZ DO
  • NPI Number: 1558385989
  • Taxonomy: 207RE0101X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D0984681
LAB Type Physician Office
Facility Name SIU PHYSICIANS & SURGEONS INC
Street 747 N RUTLEDGE - BAYLIS - FLOOR 5
City SPRINGFIELD
State IL
ZIP 62702
Phone 217 545-8000
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 2/25/2024
Certificate Expiration Date 2/24/2026
Facility Type Physician Office
Lab Director BRADLEY F. SCHWARTZ DO

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