14D2057909 CLIA NUMBER - ARCH AIR MEDICAL - SPARTA BASE

Laboratory Demographics

  • CLIA Code: 14D2057909
  • Facility Name: ARCH AIR MEDICAL - SPARTA BASE
  • Facility Address: 10125 AIRPORT RD
    SPARTA, IL
    ZIP 62286
  • Facility Phone: 314 655-4104
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: AMY J. NIEWINSKI
  • NPI Number: 1679872907
  • Taxonomy: 3416A0800X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 14D2057909
LAB Type Ambulance
Facility Name ARCH AIR MEDICAL - SPARTA BASE
Street 10125 AIRPORT RD
City SPARTA
State IL
ZIP 62286
Phone 314 655-4104
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/25/2025
Certificate Expiration Date 4/24/2027
Facility Type Ambulance
Lab Director AMY J. NIEWINSKI

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