14D0724597 CLIA NUMBER - HAVANA MEDICAL ASSOCIATES

Laboratory Demographics

  • CLIA Code: 14D0724597
  • Facility Name: HAVANA MEDICAL ASSOCIATES
  • Facility Address: 615 N PROMENADE ST
    HAVANA, IL
    ZIP 62644
  • Facility Phone: 309 543-6600
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MICHAEL S. MARKLEY
  • NPI Number: 1063478782
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D0724597
LAB Type Physician Office
Facility Name HAVANA MEDICAL ASSOCIATES
Street 615 N PROMENADE ST
City HAVANA
State IL
ZIP 62644
Phone 309 543-6600
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/26/2024
Certificate Expiration Date 10/25/2026
Facility Type Physician Office
Lab Director MICHAEL S. MARKLEY

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