14D0647011 CLIA NUMBER - CHRISTIE CLINIC LABORATORY

Laboratory Demographics

  • CLIA Code: 14D0647011
  • Facility Name: CHRISTIE CLINIC LABORATORY
  • Facility Address: 101 W UNIVERSITY AVE
    CHAMPAIGN, IL
    ZIP 61820
  • Facility Phone: 217 351-1281
  • Facility Type: Community Clinic
  • Facility Type: Accreditation
  • Lab Director: DR. KRISHNARAO V. TANGELLA
  • NPI Number: 1851971535
  • Taxonomy: 332B00000X - Durable Medical Equipment & Medical Supplies

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CLIA Record

Field Name Field Value
CLIA Number 14D0647011
LAB Type Community Clinic
Facility Name CHRISTIE CLINIC LABORATORY
Street 101 W UNIVERSITY AVE
City CHAMPAIGN
State IL
ZIP 61820
Phone 217 351-1281
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 2/28/2025
Certificate Expiration Date 2/27/2027
Facility Type Community Clinic
Lab Director DR. KRISHNARAO V. TANGELLA

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