14D1100272 CLIA NUMBER - ALTON MEMORIAL HOSPITAL AMBULANCE

Laboratory Demographics

  • CLIA Code: 14D1100272
  • Facility Name: ALTON MEMORIAL HOSPITAL AMBULANCE
  • Facility Address: ONE MEMORIAL DR
    ALTON, IL
    ZIP 62002
  • Facility Phone: 618 463-7510
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: ALEXANDER ZOZULA
  • NPI Number: 1235550294
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D1100272
LAB Type Ambulance
Facility Name ALTON MEMORIAL HOSPITAL AMBULANCE
Street ONE MEMORIAL DR
City ALTON
State IL
ZIP 62002
Phone 618 463-7510
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/3/2025
Certificate Expiration Date 6/2/2027
Facility Type Ambulance
Lab Director ALEXANDER ZOZULA

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