14D0985286 CLIA NUMBER - BENTON DIALYSIS RENAL LIFE LINK INC

Laboratory Demographics

  • CLIA Code: 14D0985286
  • Facility Name: BENTON DIALYSIS RENAL LIFE LINK INC
  • Facility Address: 1151 ROUTE 14 WEST
    BENTON, IL
    ZIP 62812
  • Facility Phone: 618 435-4850
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: CHERYL EMMONS
  • NPI Number: 1609885185
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D0985286
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name BENTON DIALYSIS RENAL LIFE LINK INC
Street 1151 ROUTE 14 WEST
City BENTON
State IL
ZIP 62812
Phone 618 435-4850
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/12/2025
Certificate Expiration Date 4/11/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director CHERYL EMMONS

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