14D2165194 CLIA NUMBER - MEMORIAL PHYSICIAN SERVICES BEARDSTOWN

Laboratory Demographics

  • CLIA Code: 14D2165194
  • Facility Name: MEMORIAL PHYSICIAN SERVICES BEARDSTOWN
  • Facility Address: 8460 ST LUKE'S DR
    BEARDSTOWN, IL
    ZIP 62618
  • Facility Phone: 217 544-0306
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ANTHONY M. GRIFFIN M D
  • NPI Number: 1245822170
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D2165194
LAB Type Physician Office
Facility Name MEMORIAL PHYSICIAN SERVICES BEARDSTOWN
Street 8460 ST LUKE'S DR
City BEARDSTOWN
State IL
ZIP 62618
Phone 217 544-0306
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/23/2025
Certificate Expiration Date 4/22/2027
Facility Type Physician Office
Lab Director ANTHONY M. GRIFFIN M D

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