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14D0948199 CLIA NUMBER - CARLINVILLE FAMILY PRACTICE MACOUPIN FAMILY PRACTICE CENTERS LLP

Laboratory Demographics

CLIA Number: 14D0948199

Facility Name: CARLINVILLE FAMILY PRACTICE MACOUPIN FAMILY PRACTICE CENTERS LLP

Facility Address:
15574 RTE 108
CARLINVILLE, IL
ZIP 62626
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Facility Phone Number: 217 854-4319

Facility Type: Physician Office

Certificate Type: Microscopy
NPI Number: 1649460510

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name Field Value
CLIA Number 14D0948199
LAB Type Physician Office
Facility Name CARLINVILLE FAMILY PRACTICE MACOUPIN FAMILY PRACTICE CENTERS LLP
Street 15574 RTE 108
City CARLINVILLE
State IL
ZIP 62626
Phone 217 854-4319
CertificateType 3
CertificateEffectiveDate 3/17/2023
CertificateExpirationDate 3/16/2025
FacilityType PPMP

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This page was last updated on: 4/23/2024