14D2131457 CLIA NUMBER - METRO EAST DERMATOLOGY

Laboratory Demographics

  • CLIA Code: 14D2131457
  • Facility Name: METRO EAST DERMATOLOGY
  • Facility Address: 331 REGENCY PARK
    O FALLON, IL
    ZIP 62269
  • Facility Phone: 618 622-7546
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: JAMIE L. MCGINNESS
  • NPI Number: 1154939312
  • Taxonomy: 291U00000X - Clinical Medical Laboratory

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CLIA Record

Field Name Field Value
CLIA Number 14D2131457
LAB Type Physician Office
Facility Name METRO EAST DERMATOLOGY
Street 331 REGENCY PARK
City O FALLON
State IL
ZIP 62269
Phone 618 622-7546
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 12/5/2023
Certificate Expiration Date 12/4/2025
Facility Type Physician Office
Lab Director JAMIE L. MCGINNESS

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