14D0721547 CLIA NUMBER - MACKINAW DOCTORS OFFICE

Laboratory Demographics

  • CLIA Code: 14D0721547
  • Facility Name: MACKINAW DOCTORS OFFICE
  • Facility Address: 116 MAIN ST
    MACKINAW, IL
    ZIP 61755
  • Facility Phone: 309 449-4338
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ALFRED N. ROSSI
  • NPI Number: 1295884708
  • Taxonomy: 3416L0300X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 14D0721547
LAB Type Physician Office
Facility Name MACKINAW DOCTORS OFFICE
Street 116 MAIN ST
City MACKINAW
State IL
ZIP 61755
Phone 309 449-4338
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/20/2024
Certificate Expiration Date 8/19/2026
Facility Type Physician Office
Lab Director ALFRED N. ROSSI

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