14D1089515 CLIA NUMBER - KAUSHAL PEDIATRIC SERVICES LTD

Laboratory Demographics

  • CLIA Code: 14D1089515
  • Facility Name: KAUSHAL PEDIATRIC SERVICES LTD
  • Facility Address: 4107 N WATER TOWER PLACE
    MOUNT VERNON, IL
    ZIP 62864
  • Facility Phone: 618 242-5437
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: NEETA B. KAUSHAL
  • NPI Number: 1538326582
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 14D1089515
LAB Type Physician Office
Facility Name KAUSHAL PEDIATRIC SERVICES LTD
Street 4107 N WATER TOWER PLACE
City MOUNT VERNON
State IL
ZIP 62864
Phone 618 242-5437
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/19/2024
Certificate Expiration Date 9/18/2026
Facility Type Physician Office
Lab Director NEETA B. KAUSHAL

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