14D2326049 CLIA NUMBER - SCOTT AIR FORCE BASE OUTPATIENT CLINIC

Laboratory Demographics

  • CLIA Code: 14D2326049
  • Facility Name: SCOTT AIR FORCE BASE OUTPATIENT CLINIC
  • Facility Address: 310 W LOSEY ST
    SCOTT AIR FORCE BASE, IL
    ZIP 62225
  • Facility Phone: 314 652-4100
  • Facility Type: Community Clinic
  • Facility Type: Accreditation
  • Lab Director: PATRICK ADEGBOYEGA
  • NPI Number: 1093192908
  • Taxonomy: 261QV0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D2326049
LAB Type Community Clinic
Facility Name SCOTT AIR FORCE BASE OUTPATIENT CLINIC
Street 310 W LOSEY ST
City SCOTT AIR FORCE BASE
State IL
ZIP 62225
Phone 314 652-4100
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 6/26/2025
Certificate Expiration Date 5/22/2026
Facility Type Community Clinic
Lab Director PATRICK ADEGBOYEGA

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