14D0984682 CLIA NUMBER - SPRINGFIELD CLINIC CARLINVILLE

Laboratory Demographics

  • CLIA Code: 14D0984682
  • Facility Name: SPRINGFIELD CLINIC CARLINVILLE
  • Facility Address: 20613 N BROAD ST
    CARLINVILLE, IL
    ZIP 62626
  • Facility Phone: 217 854-5099
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ELIZABETH O BRIEN M D
  • NPI Number: 1437369030
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D0984682
LAB Type Physician Office
Facility Name SPRINGFIELD CLINIC CARLINVILLE
Street 20613 N BROAD ST
City CARLINVILLE
State IL
ZIP 62626
Phone 217 854-5099
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/3/2023
Certificate Expiration Date 11/2/2025
Facility Type Physician Office
Lab Director ELIZABETH O BRIEN M D

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