14D1063723 CLIA NUMBER - METRO EAST HEALTHCARE LTD

Laboratory Demographics

CLIA Number: 14D1063723

Facility Name: METRO EAST HEALTHCARE LTD

Facility Address:
2133 VADALABENE DR, STE 5B
MARYVILLE, IL
ZIP 62062
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Facility Phone Number: 618 288-7605

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1083767479

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	14D1063723
LAB Type	Physician Office
Facility Name	METRO EAST HEALTHCARE LTD
Street	2133 VADALABENE DR, STE 5B
City	MARYVILLE
State	IL
ZIP	62062
Phone	618 288-7605
CertificateType	4
CertificateEffectiveDate	8/20/2023
CertificateExpirationDate	8/19/2025
FacilityType	Waiver

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