14D2161741 CLIA NUMBER - WASHINGTON UNIV PHYSICIANS IN ILLINOIS UROLOGY

Laboratory Demographics

  • CLIA Code: 14D2161741
  • Facility Name: WASHINGTON UNIV PHYSICIANS IN ILLINOIS UROLOGY
  • Facility Address: 1418 CROSS ST - MOB 2 STE 180
    SHILOH, IL
    ZIP 62269
  • Facility Phone: 314 362-8200
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: MICHAEL H. JOHNSON
  • NPI Number: 1730327842
  • Taxonomy: 332B00000X - Durable Medical Equipment & Medical Supplies

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CLIA Record

Field Name Field Value
CLIA Number 14D2161741
LAB Type Physician Office
Facility Name WASHINGTON UNIV PHYSICIANS IN ILLINOIS UROLOGY
Street 1418 CROSS ST - MOB 2 STE 180
City SHILOH
State IL
ZIP 62269
Phone 314 362-8200
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 3/16/2025
Certificate Expiration Date 3/15/2027
Facility Type Physician Office
Lab Director MICHAEL H. JOHNSON

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