14D2312327 CLIA NUMBER - ADVANCED PRACTICE NURSING SERVICES, INC

Laboratory Demographics

  • CLIA Code: 14D2312327
  • Facility Name: ADVANCED PRACTICE NURSING SERVICES, INC
  • Facility Address: 1254 W MAIN ST
    MASCOUTAH, IL
    ZIP 62258
  • Facility Phone: 618 792-3586
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: KELLY M. WHITAKER
  • NPI Number: 1861867863
  • Taxonomy: 363LA2200X - Nurse Practitioner

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 14D2312327
LAB Type Practitioner Other
Facility Name ADVANCED PRACTICE NURSING SERVICES, INC
Street 1254 W MAIN ST
City MASCOUTAH
State IL
ZIP 62258
Phone 618 792-3586
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/9/2024
Certificate Expiration Date 10/8/2026
Facility Type Practitioner Other
Lab Director KELLY M. WHITAKER

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