CLIA lab
CLIA 14D1039929: Michael E Mandis MD LLC
Maryville, IL. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 14D1039929 belongs to Michael E Mandis MD LLC in Maryville, IL.
Certificate of Waiver, effective April 26, 2025, expires April 25, 2027.
Active in the CMS Provider of Services file posted October 16, 2026.
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
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Certificate
- Certificate type
- Certificate of Waiver
- Certificate effective
- April 26, 2025
- Certificate expiration
- April 25, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- April 26, 2005
- Facility type
- Physician office
- Ownership (control type)
- Other
- Lab classification
- CLIA laboratory
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 14D1039929
- Lab name
- Michael E Mandis MD LLC
- Address
- 2236 Vadalabene Dr, Ste 2, Maryville, IL 62062
- Phone
- (618) 391-5540
- Fax
- (618) 288-6143
Annual test volume the lab reported
- Waived tests
- 10,000
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
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- Allergy, Asthma & Immunology CenterCertificate for Provider-Performed Microscopy Procedures, Physician office14D2330086
- Amg Internal Medicine of MaryvilleCertificate of Waiver, Physician office14D2142110
- Anderson Hosp Resp Care-Blood Gas LabCertificate of Accreditation, Other14D0860968
- Anderson HospitalCertificate of Waiver, Hospital14D0962052
- Anderson Hospital EMSCertificate of Waiver, Ambulance14D0985493
- Anderson Hospital LabCertificate of Accreditation, Hospital14D0433735
- Anderson Med Group - Family Medicine of MaryvilleCertificate of Waiver, Physician office14D0433428
Related
Questions
What is the CLIA number for Michael E Mandis MD LLC in Maryville?
14D1039929, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Michael E Mandis MD LLC hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 14D1039929 expire?
The CMS file lists April 25, 2027 as the certificate expiration date; the certificate took effect April 26, 2025.