14D0989753 CLIA NUMBER - JODY L KELLY MD & ASSOCIATES LLC

Laboratory Demographics

  • CLIA Code: 14D0989753
  • Facility Name: JODY L KELLY MD & ASSOCIATES LLC
  • Facility Address: 2901 N KNOXVILLE AVE
    PEORIA, IL
    ZIP 61603
  • Facility Phone: 309 688-7010
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JODY L. KELLY
  • NPI Number: 1932107208
  • Taxonomy: 207V00000X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 14D0989753
LAB Type Physician Office
Facility Name JODY L KELLY MD & ASSOCIATES LLC
Street 2901 N KNOXVILLE AVE
City PEORIA
State IL
ZIP 61603
Phone 309 688-7010
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/1/2024
Certificate Expiration Date 4/30/2026
Facility Type Physician Office
Lab Director JODY L. KELLY

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