14D2149035 CLIA NUMBER - BHARAT PATEL, MD MASSAC MEMORIAL CLINIC

Laboratory Demographics

  • CLIA Code: 14D2149035
  • Facility Name: BHARAT PATEL, MD MASSAC MEMORIAL CLINIC
  • Facility Address: 1204 W 10TH ST - STE C
    METROPOLIS, IL
    ZIP 62960
  • Facility Phone: 618 524-2182
  • Facility Type: Rural Health Clinic
  • Facility Type: Waiver
  • Lab Director: BHARAT K. PATEL
  • NPI Number: 1417303181
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D2149035
LAB Type Rural Health Clinic
Facility Name BHARAT PATEL, MD MASSAC MEMORIAL CLINIC
Street 1204 W 10TH ST - STE C
City METROPOLIS
State IL
ZIP 62960
Phone 618 524-2182
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/23/2024
Certificate Expiration Date 5/22/2026
Facility Type Rural Health Clinic
Lab Director BHARAT K. PATEL

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