14D0433754 CLIA NUMBER - JCH MEDICAL GROUP JERSEY COMMUNITY HOSPITAL D/B/A

Laboratory Demographics

  • CLIA Code: 14D0433754
  • Facility Name: JCH MEDICAL GROUP JERSEY COMMUNITY HOSPITAL D/B/A
  • Facility Address: 414 S STATE ST
    ROODHOUSE, IL
    ZIP 62082
  • Facility Phone: 618 498-7518
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: TIMOTHY L. LYONS M D
  • NPI Number: 1770988735
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D0433754
LAB Type Physician Office
Facility Name JCH MEDICAL GROUP JERSEY COMMUNITY HOSPITAL D/B/A
Street 414 S STATE ST
City ROODHOUSE
State IL
ZIP 62082
Phone 618 498-7518
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 2/5/2024
Certificate Expiration Date 2/4/2026
Facility Type Physician Office
Lab Director TIMOTHY L. LYONS M D

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This page was last updated on: 9/29/2025