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14D1041285 CLIA NUMBER - CHRISTINA L MIDKIFF M D S C

Laboratory Demographics

CLIA Number: 14D1041285

Facility Name: CHRISTINA L MIDKIFF M D S C

Facility Address:
2023 VADALABENE DRIVE, STE 200
MARYVILLE, IL
ZIP 62062
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Facility Phone Number: 618 288-7408

Facility Type: Physician Office

Certificate Type: Microscopy
NPI Number: 1306825856

Taxonomy: 207VG0400X - Obstetrics & Gynecology
A physician who specializes in diagnosis, treatment, and management of patients with gynecologic conditions. Source: National Uniform Claim Committee

CLIA Record

Field Name Field Value
CLIA Number 14D1041285
LAB Type Physician Office
Facility Name CHRISTINA L MIDKIFF M D S C
Street 2023 VADALABENE DRIVE, STE 200
City MARYVILLE
State IL
ZIP 62062
Phone 618 288-7408
CertificateType 3
CertificateEffectiveDate 11/28/2023
CertificateExpirationDate 11/27/2025
FacilityType PPMP

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