14D2104688 CLIA NUMBER - MEMORIAL HOSPITAL EAST METRO EAST SERVICES INC DBA

Laboratory Demographics

  • CLIA Code: 14D2104688
  • Facility Name: MEMORIAL HOSPITAL EAST METRO EAST SERVICES INC DBA
  • Facility Address: 1404 CROSS ST
    SHILOH, IL
    ZIP 62269
  • Facility Phone: 618 257-5115
  • Facility Type: Hospital
  • Facility Type: Accreditation
  • Lab Director: DR. NICOLE V. TOLAN
  • NPI Number: 1396142139
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D2104688
LAB Type Hospital
Facility Name MEMORIAL HOSPITAL EAST METRO EAST SERVICES INC DBA
Street 1404 CROSS ST
City SHILOH
State IL
ZIP 62269
Phone 618 257-5115
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 4/19/2025
Certificate Expiration Date 4/18/2027
Facility Type Hospital
Lab Director DR. NICOLE V. TOLAN

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