14D0889599 CLIA NUMBER - KNOX COUNTY HEALTH DEPARTMENT

Laboratory Demographics

  • CLIA Code: 14D0889599
  • Facility Name: KNOX COUNTY HEALTH DEPARTMENT
  • Facility Address: 1361 W FREMONT
    GALESBURG, IL
    ZIP 61401
  • Facility Phone: 309 344-2225
  • Facility Type: Other - HEALTH DEPARTMENT W/FQHC
  • Facility Type: Waiver
  • Lab Director: ROBERT H. WAGNER
  • NPI Number: 1912090515
  • Taxonomy: 261QH0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D0889599
LAB Type Other - HEALTH DEPARTMENT W/FQHC
Facility Name KNOX COUNTY HEALTH DEPARTMENT
Street 1361 W FREMONT
City GALESBURG
State IL
ZIP 61401
Phone 309 344-2225
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/19/2023
Certificate Expiration Date 12/18/2025
Facility Type Other - HEALTH DEPARTMENT W/FQHC
Lab Director ROBERT H. WAGNER

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