14D2064079 CLIA NUMBER - MERCYONE GENESIS MOLINE HEALTH PLAZA

Laboratory Demographics

  • CLIA Code: 14D2064079
  • Facility Name: MERCYONE GENESIS MOLINE HEALTH PLAZA
  • Facility Address: 3900 28TH AVE DR
    MOLINE, IL
    ZIP 61265
  • Facility Phone: 309 281-6083
  • Facility Type: Ancillary Testing Site in Health Care Center
  • Facility Type: Certificate of Compliance
  • Lab Director: ROBERT MIXSELL
  • NPI Number: 1760412068
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D2064079
LAB Type Ancillary Testing Site in Health Care Center
Facility Name MERCYONE GENESIS MOLINE HEALTH PLAZA
Street 3900 28TH AVE DR
City MOLINE
State IL
ZIP 61265
Phone 309 281-6083
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 4/25/2024
Certificate Expiration Date 4/24/2026
Facility Type Ancillary Testing Site in Health Care Center
Lab Director ROBERT MIXSELL

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