14D2107698 CLIA NUMBER - MEDICAL SERVICES UNLIMITED

Laboratory Demographics

CLIA Number: 14D2107698

Facility Name: MEDICAL SERVICES UNLIMITED

Facility Address:
1404 NORTH 5TH ST
VANDALIA, IL
ZIP 62471
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Facility Phone Number: 618 971-1440

Facility Type: Rural Health Clinic

Certificate Type: Waiver

NPI Number: 1528185170

Taxonomy: 261QR1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	14D2107698
LAB Type	Rural Health Clinic
Facility Name	MEDICAL SERVICES UNLIMITED
Street	1404 NORTH 5TH ST
City	VANDALIA
State	IL
ZIP	62471
Phone	618 971-1440
CertificateType	4
CertificateEffectiveDate	1/20/2024
CertificateExpirationDate	1/19/2026
FacilityType	Waiver

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