Clinical Laboratory Information
Similar CLIA Codes
|
|
CLIA Number
|
14D2047370
|
|
Clinical laboratory number
|
|
Lab Name
|
SHILOH DIALYSIS (DBA)
|
|
Laboratory Name
|
|
Lab Type
|
End Stage Renal Disease Dialysis Facility
|
|
Laboratory Type
|
|
Certificate Type
|
Waiver
|
|
Clinical laboratory certificate type
|
Contacts |
|
Phone
|
618-628-1108
|
|
Laboratory telephone number
|
|
Fax
|
618-628-1459
|
|
Fax number of the provider.
|
Facility Location |
|
Street Address
|
1095 N GREEN MOUNT RD
|
|
Primary location adress line
|
|
City
|
BELLEVILLE
|
|
Primary location city name
|
|
State
|
IL
|
|
Primary location state name
|
|
Zip
|
62221-3303
|
|
Primary location postal code
|