14D2307897 CLIA NUMBER - SPRINGFIELD CLINIC RADIOLOGY 800 1ST

Laboratory Demographics

  • CLIA Code: 14D2307897
  • Facility Name: SPRINGFIELD CLINIC RADIOLOGY 800 1ST
  • Facility Address: 800 N 1ST ST
    SPRINGFIELD, IL
    ZIP 62702
  • Facility Phone: (217) 528-7451
  • Facility Type: Ancillary Testing Site in Health Care Center
  • Facility Type: Waiver
  • Lab Director: BROOKLYN LOOS
  • NPI Number: 1124785779
  • Taxonomy: 174H00000X - Health Educator

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CLIA Record

Field Name Field Value
CLIA Number 14D2307897
LAB Type Ancillary Testing Site in Health Care Center
Facility Name SPRINGFIELD CLINIC RADIOLOGY 800 1ST
Street 800 N 1ST ST
City SPRINGFIELD
State IL
ZIP 62702
Phone 2175287451
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/17/2024
Certificate Expiration Date 7/16/2026
Facility Type Ancillary Testing Site in Health Care Center
Lab Director BROOKLYN LOOS

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This page was last updated on: 5/18/2026