14D2086592 CLIA NUMBER - HSHS MED GROUP GENERAL SURGERY-BREESE

Laboratory Demographics

  • CLIA Code: 14D2086592
  • Facility Name: HSHS MED GROUP GENERAL SURGERY-BREESE
  • Facility Address: 9515 HOLY CROSS LN, STE 175
    BREESE, IL
    ZIP 62230
  • Facility Phone: 618 526-8430
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ULUNNA MACBEAN
  • NPI Number: 1740677533
  • Taxonomy: 332B00000X - Durable Medical Equipment & Medical Supplies

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 14D2086592
LAB Type Physician Office
Facility Name HSHS MED GROUP GENERAL SURGERY-BREESE
Street 9515 HOLY CROSS LN, STE 175
City BREESE
State IL
ZIP 62230
Phone 618 526-8430
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/6/2024
Certificate Expiration Date 11/5/2026
Facility Type Physician Office
Lab Director ULUNNA MACBEAN

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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