14D2179257 CLIA NUMBER - CANCER CARE SPECIALISTS OF ILLINOIS

Laboratory Demographics

CLIA Number: 14D2179257

Facility Name: CANCER CARE SPECIALISTS OF ILLINOIS

Facility Address:
321 REGENCY PARK
O FALLON, IL
ZIP 62269
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Facility Phone Number: 217 876-6600

Facility Type: Physician Office

Certificate Type: Accreditation

NPI Number: 1356874093

Taxonomy: 3336C0003X - Pharmacy
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

CLIA Record

Field Name	Field Value
CLIA Number	14D2179257
LAB Type	Physician Office
Facility Name	CANCER CARE SPECIALISTS OF ILLINOIS
Street	321 REGENCY PARK
City	O FALLON
State	IL
ZIP	62269
Phone	217 876-6600
CertificateType	1
CertificateEffectiveDate	3/24/2023
CertificateExpirationDate	3/23/2025
FacilityType	Accreditation

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