14D2011705 CLIA NUMBER - AHS IL MEDICAL GROUP LLC

Home > CLIA Lookup > 14D2011705

Laboratory Demographics

CLIA Number: 14D2011705

Facility Name: AHS IL MEDICAL GROUP LLC

Facility Address:
101 UNITED DR - STE 140
COLLINSVILLE, IL
ZIP 62234
Get Directions

Facility Phone Number: 618 344-0248

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1336209329

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	14D2011705
LAB Type	Physician Office
Facility Name	AHS IL MEDICAL GROUP LLC
Street	101 UNITED DR - STE 140
City	COLLINSVILLE
State	IL
ZIP	62234
Phone	618 344-0248
CertificateType	4
CertificateEffectiveDate	8/20/2022
CertificateExpirationDate	8/19/2024
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

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