14D2104323 CLIA NUMBER - STH FAMILY HEALTHCARE CENTER

Laboratory Demographics

CLIA Number: 14D2104323

Facility Name: STH FAMILY HEALTHCARE CENTER

Facility Address:
1321 W WHITTAKER
SALEM, IL
ZIP 62881
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Facility Phone Number: 618 548-0200

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1629433784

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	14D2104323
LAB Type	Physician Office
Facility Name	STH FAMILY HEALTHCARE CENTER
Street	1321 W WHITTAKER
City	SALEM
State	IL
ZIP	62881
Phone	618 548-0200
CertificateType	4
CertificateEffectiveDate	11/2/2023
CertificateExpirationDate	11/1/2025
FacilityType	Waiver

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