14D1023892 CLIA NUMBER - MED-PLUS PHYSICAL MEDICINE LLC

Laboratory Demographics

  • CLIA Code: 14D1023892
  • Facility Name: MED-PLUS PHYSICAL MEDICINE LLC
  • Facility Address: 18209 EULA MAE PKWY
    CARLYLE, IL
    ZIP 62231
  • Facility Phone: 618 594-3671
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: GREGORY COLLINS
  • NPI Number: 1386945210
  • Taxonomy: 111N00000X - Chiropractor

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CLIA Record

Field Name Field Value
CLIA Number 14D1023892
LAB Type Physician Office
Facility Name MED-PLUS PHYSICAL MEDICINE LLC
Street 18209 EULA MAE PKWY
City CARLYLE
State IL
ZIP 62231
Phone 618 594-3671
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/29/2024
Certificate Expiration Date 3/28/2026
Facility Type Physician Office
Lab Director GREGORY COLLINS

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