14D2151919 CLIA NUMBER - M FITNESS, HEALTH & WELLNESS

Laboratory Demographics

  • CLIA Code: 14D2151919
  • Facility Name: M FITNESS, HEALTH & WELLNESS
  • Facility Address: 3450-B LIBERTY DR
    SPRINGFIELD, IL
    ZIP 62711
  • Facility Phone: 217 402-8455
  • Facility Type: Other - HEALTH BEHAVIOR FIELD
  • Facility Type: Waiver
  • Lab Director: EMILY KLOCKENGA
  • NPI Number: 1093285454
  • Taxonomy: 174H00000X - Health Educator

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CLIA Record

Field Name Field Value
CLIA Number 14D2151919
LAB Type Other - HEALTH BEHAVIOR FIELD
Facility Name M FITNESS, HEALTH & WELLNESS
Street 3450-B LIBERTY DR
City SPRINGFIELD
State IL
ZIP 62711
Phone 217 402-8455
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/31/2024
Certificate Expiration Date 7/30/2026
Facility Type Other - HEALTH BEHAVIOR FIELD
Lab Director EMILY KLOCKENGA

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