14D2074735 CLIA NUMBER - SOUTHERN ILLINOIS G I SPECIALISTS L L C

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Laboratory Demographics

CLIA Number: 14D2074735

Facility Name: SOUTHERN ILLINOIS G I SPECIALISTS L L C

Facility Address:
1100 WEST DIANN LANE
CARBONDALE, IL
ZIP 62901
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Facility Phone Number: 618 549-8006

Facility Type: Physician Office

Certificate Type: Accreditation

NPI Number: 1093775405

Taxonomy: 207RG0100X - Internal Medicine
An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.

CLIA Record

Field Name	Field Value
CLIA Number	14D2074735
LAB Type	Physician Office
Facility Name	SOUTHERN ILLINOIS G I SPECIALISTS L L C
Street	1100 WEST DIANN LANE
City	CARBONDALE
State	IL
ZIP	62901
Phone	618 549-8006
CertificateType	1
CertificateEffectiveDate	4/20/2024
CertificateExpirationDate	4/19/2026
FacilityType	Accreditation

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