14D0710428 CLIA NUMBER - PEKIN FAMILY PRACTICE P C

Laboratory Demographics

  • CLIA Code: 14D0710428
  • Facility Name: PEKIN FAMILY PRACTICE P C
  • Facility Address: 2401 BROADWAY ST - LOWER LEVEL
    PEKIN, IL
    ZIP 61554
  • Facility Phone: 309 349-8700
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CURTIS W. FISHER II, D O
  • NPI Number: 1538138938
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D0710428
LAB Type Physician Office
Facility Name PEKIN FAMILY PRACTICE P C
Street 2401 BROADWAY ST - LOWER LEVEL
City PEKIN
State IL
ZIP 61554
Phone 309 349-8700
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/28/2024
Certificate Expiration Date 8/27/2026
Facility Type Physician Office
Lab Director CURTIS W. FISHER II, D O

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