CLIA lab
CLIA 14D2099049: Southern Illinois Dermatology
Mount Vernon, IL. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 14D2099049 belongs to Southern Illinois Dermatology in Mount Vernon, IL.
Certificate for Provider-Performed Microscopy Procedures, effective July 20, 2025, expires July 19, 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 for Provider-Performed Microscopy Procedures
- Certificate effective
- July 20, 2025
- Certificate expiration
- July 19, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- July 20, 2015
- Facility type
- Physician office
- Ownership (control type)
- Proprietary
- 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
- 14D2099049
- Lab name
- Southern Illinois Dermatology
- Address
- 1007 South 42nd St, Mount Vernon, IL 62864
- Phone
- (618) 942-3344
- Fax
- (618) 942-5045
Annual test volume the lab reported
- Provider-performed microscopy tests
- 100
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
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Related
Questions
What is the CLIA number for Southern Illinois Dermatology in Mount Vernon?
14D2099049, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Southern Illinois Dermatology hold?
A Certificate for Provider-Performed Microscopy Procedures, according to the CMS file.
When does CLIA 14D2099049 expire?
The CMS file lists July 19, 2027 as the certificate expiration date; the certificate took effect July 20, 2025.