14D2167604 CLIA NUMBER - BELLEVILLE URGENT CARE WALK-IN CLINIC

Laboratory Demographics

CLIA Number: 14D2167604

Facility Name: BELLEVILLE URGENT CARE WALK-IN CLINIC

Facility Address:
2801 W MAIN ST
BELLEVILLE, IL
ZIP 62226
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Facility Phone Number: 248 250-6420

Facility Type: Other - URGENT CARE

Certificate Type: Waiver

NPI Number: 1093288524

Taxonomy: 1223G0001X - Dentist
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

CLIA Record

Field Name	Field Value
CLIA Number	14D2167604
LAB Type	Other - URGENT CARE
Facility Name	BELLEVILLE URGENT CARE WALK-IN CLINIC
Street	2801 W MAIN ST
City	BELLEVILLE
State	IL
ZIP	62226
Phone	248 250-6420
CertificateType	4
CertificateEffectiveDate	6/11/2023
CertificateExpirationDate	6/10/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024