14D1087512 CLIA NUMBER - MUSICK DERMATOLOGY & ADVANCED CLINICAL SPA, L L C

Laboratory Demographics

  • CLIA Code: 14D1087512
  • Facility Name: MUSICK DERMATOLOGY & ADVANCED CLINICAL SPA, L L C
  • Facility Address: 4948 BENCHMARK CENTRE DR
    SWANSEA, IL
    ZIP 62226
  • Facility Phone: 618 628-2588
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: STEVE E. MUSICK M D
  • NPI Number: 1922260587
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 14D1087512
LAB Type Physician Office
Facility Name MUSICK DERMATOLOGY & ADVANCED CLINICAL SPA, L L C
Street 4948 BENCHMARK CENTRE DR
City SWANSEA
State IL
ZIP 62226
Phone 618 628-2588
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/17/2023
Certificate Expiration Date 10/16/2025
Facility Type Physician Office
Lab Director STEVE E. MUSICK M D

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This page was last updated on: 6/4/2025