14D0429729 CLIA NUMBER - LENA BRANCH - MONROE CLINIC

Laboratory Demographics

CLIA Number: 14D0429729

Facility Name: LENA BRANCH - MONROE CLINIC

Facility Address:
214 N SCHUYLER ST
LENA, IL
ZIP 61048
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Facility Phone Number: 815 369-4541

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1245576347

Taxonomy: 283X00000X - Rehabilitation Hospital
A hospital or facility that provides health-related, social and/or vocational services to disabled persons to help them attain their maximum functional capacity.

CLIA Record

Field Name	Field Value
CLIA Number	14D0429729
LAB Type	Physician Office
Facility Name	LENA BRANCH - MONROE CLINIC
Street	214 N SCHUYLER ST
City	LENA
State	IL
ZIP	61048
Phone	815 369-4541
CertificateType	4
CertificateEffectiveDate	3/22/2024
CertificateExpirationDate	3/21/2026
FacilityType	Waiver

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This page was last updated on: 4/23/2024