26D2240209 CLIA NUMBER - ILLUMINATION HEALTH, LLC

Laboratory Demographics

  • CLIA Code: 26D2240209
  • Facility Name: ILLUMINATION HEALTH, LLC
  • Facility Address: 2355 DOUGHERTY FERRY RD, STE 408
    DES PERES, MO
    ZIP 63122
  • Facility Phone: 314 835-4873
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SARA HAWATMEH
  • NPI Number: 1992378384
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 26D2240209
LAB Type Physician Office
Facility Name ILLUMINATION HEALTH, LLC
Street 2355 DOUGHERTY FERRY RD, STE 408
City DES PERES
State MO
ZIP 63122
Phone 314 835-4873
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/18/2023
Certificate Expiration Date 10/17/2025
Facility Type Physician Office
Lab Director SARA HAWATMEH

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