14D0985493 CLIA NUMBER - ANDERSON HOSPITAL EMS

Laboratory Demographics

  • CLIA Code: 14D0985493
  • Facility Name: ANDERSON HOSPITAL EMS
  • Facility Address: 6800 STATE ROUTE 162
    MARYVILLE, IL
    ZIP 62062
  • Facility Phone: 618 288-5711
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: ANDREW RUSSELL M D
  • NPI Number: 1053481630
  • Taxonomy: 282N00000X - General Acute Care Hospital

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CLIA Record

Field Name Field Value
CLIA Number 14D0985493
LAB Type Ambulance
Facility Name ANDERSON HOSPITAL EMS
Street 6800 STATE ROUTE 162
City MARYVILLE
State IL
ZIP 62062
Phone 618 288-5711
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/20/2025
Certificate Expiration Date 4/19/2027
Facility Type Ambulance
Lab Director ANDREW RUSSELL M D

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