14D0950288 CLIA NUMBER - JCH MEDICAL GROUP JERSEY COMMUNITY HOSPITAL D/B/A

Laboratory Demographics

  • CLIA Code: 14D0950288
  • Facility Name: JCH MEDICAL GROUP JERSEY COMMUNITY HOSPITAL D/B/A
  • Facility Address: 523 SOUTH MAIN STREET
    CARROLLTON, IL
    ZIP 62016
  • Facility Phone: 618 498-7518
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CRISTY A. ELVING-DIAL M D
  • NPI Number: 1689079642
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D0950288
LAB Type Physician Office
Facility Name JCH MEDICAL GROUP JERSEY COMMUNITY HOSPITAL D/B/A
Street 523 SOUTH MAIN STREET
City CARROLLTON
State IL
ZIP 62016
Phone 618 498-7518
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/8/2024
Certificate Expiration Date 3/7/2026
Facility Type Physician Office
Lab Director CRISTY A. ELVING-DIAL M D

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