14D1014582 CLIA NUMBER - CORK MEDICAL CENTER

Laboratory Demographics

CLIA Number: 14D1014582

Facility Name: CORK MEDICAL CENTER

Facility Address:
408 N 2ND ST
MARSHALL, IL
ZIP 62441
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Facility Phone Number: 217 826-2361

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1952335192

Taxonomy: 261QR1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	14D1014582
LAB Type	Physician Office
Facility Name	CORK MEDICAL CENTER
Street	408 N 2ND ST
City	MARSHALL
State	IL
ZIP	62441
Phone	217 826-2361
CertificateType	3
CertificateEffectiveDate	7/10/2023
CertificateExpirationDate	7/9/2025
FacilityType	PPMP

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