14D2158694 CLIA NUMBER - CHRISTINA H DOTHAGER, M D, L L C

Laboratory Demographics

  • CLIA Code: 14D2158694
  • Facility Name: CHRISTINA H DOTHAGER, M D, L L C
  • Facility Address: 787 SUNSET BLVD - STE 200
    O FALLON, IL
    ZIP 62269
  • Facility Phone: 618 726-2229
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: CHRISTINA H. DOTHAGER M D
  • NPI Number: 1508067596
  • Taxonomy: 207V00000X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 14D2158694
LAB Type Physician Office
Facility Name CHRISTINA H DOTHAGER, M D, L L C
Street 787 SUNSET BLVD - STE 200
City O FALLON
State IL
ZIP 62269
Phone 618 726-2229
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 12/4/2024
Certificate Expiration Date 12/3/2026
Facility Type Physician Office
Lab Director CHRISTINA H. DOTHAGER M D

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