14D0431497 CLIA NUMBER - GRAHAM HOSPITAL ASSOCIATION LABORATORY

Laboratory Demographics

CLIA Number: 14D0431497

Facility Name: GRAHAM HOSPITAL ASSOCIATION LABORATORY

Facility Address:
210 W WALNUT ST
CANTON, IL
ZIP 61520
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Facility Phone Number: 309 647-5240

Facility Type: Hospital

Certificate Type: Accreditation

NPI Number: 1154518454

Taxonomy: 207QA0505X - Family Medicine
The National Uniform Claim Committee (NUCC) recommends code 207QA0505X not be used. Choose a more appropriate code.

CLIA Record

Field Name	Field Value
CLIA Number	14D0431497
LAB Type	Hospital
Facility Name	GRAHAM HOSPITAL ASSOCIATION LABORATORY
Street	210 W WALNUT ST
City	CANTON
State	IL
ZIP	61520
Phone	309 647-5240
CertificateType	1
CertificateEffectiveDate	2/28/2023
CertificateExpirationDate	2/27/2025
FacilityType	Accreditation

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