14D0889496 CLIA NUMBER - BRAIDWOOD FIRE DEPARTMENT

Laboratory Demographics

  • CLIA Code: 14D0889496
  • Facility Name: BRAIDWOOD FIRE DEPARTMENT
  • Facility Address: 275 WEST MAIN ST PO BOX 309
    BRAIDWOOD, IL
    ZIP 60408
  • Facility Phone: 815 458-2000
  • Facility Type: Other
  • Facility Type: Waiver
  • Lab Director: TONYA R. CAVANAUGH
  • NPI Number: 1801801782
  • Taxonomy: 3416L0300X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 14D0889496
LAB Type Other
Facility Name BRAIDWOOD FIRE DEPARTMENT
Street 275 WEST MAIN ST PO BOX 309
City BRAIDWOOD
State IL
ZIP 60408
Phone 815 458-2000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/29/2024
Certificate Expiration Date 7/28/2026
Facility Type Other
Lab Director TONYA R. CAVANAUGH

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