14D0910807 CLIA NUMBER - OSF MULTI-SPECIALTY GROUP - FORT JESSE FAMILY MED

Laboratory Demographics

  • CLIA Code: 14D0910807
  • Facility Name: OSF MULTI-SPECIALTY GROUP - FORT JESSE FAMILY MED
  • Facility Address: 2200 FORT JESSE RD, SUITE 110
    NORMAL, IL
    ZIP 61761
  • Facility Phone: 309 661-6290
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JOSEPH LIU MD
  • NPI Number: 1902449382
  • Taxonomy: 332900000X - Non-Pharmacy Dispensing Site

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CLIA Record

Field Name Field Value
CLIA Number 14D0910807
LAB Type Physician Office
Facility Name OSF MULTI-SPECIALTY GROUP - FORT JESSE FAMILY MED
Street 2200 FORT JESSE RD, SUITE 110
City NORMAL
State IL
ZIP 61761
Phone 309 661-6290
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/12/2025
Certificate Expiration Date 1/11/2027
Facility Type Physician Office
Lab Director JOSEPH LIU MD

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