14D2177658 CLIA NUMBER - EVERSIDE HEALTH PEORIA CLINIC (PPS)

Laboratory Demographics

  • CLIA Code: 14D2177658
  • Facility Name: EVERSIDE HEALTH PEORIA CLINIC (PPS)
  • Facility Address: 1524 W GLEN AVE
    PEORIA, IL
    ZIP 61614
  • Facility Phone: 309 512-0902
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MICHAEL SPRINGER
  • NPI Number: 1700320579
  • Taxonomy: 261QP2300X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 14D2177658
LAB Type Physician Office
Facility Name EVERSIDE HEALTH PEORIA CLINIC (PPS)
Street 1524 W GLEN AVE
City PEORIA
State IL
ZIP 61614
Phone 309 512-0902
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/15/2024
Certificate Expiration Date 1/14/2026
Facility Type Physician Office
Lab Director MICHAEL SPRINGER

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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