14D1039067 CLIA NUMBER - GILLESPIE RURAL HEALTH CLINIC

Laboratory Demographics

  • CLIA Code: 14D1039067
  • Facility Name: GILLESPIE RURAL HEALTH CLINIC
  • Facility Address: 807 BROADWAY ST
    GILLESPIE, IL
    ZIP 62033
  • Facility Phone: 217 854-3851
  • Facility Type: Rural Health Clinic
  • Facility Type: Waiver
  • Lab Director: KATE M. EMMERLICH
  • NPI Number: 1215088000
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 14D1039067
LAB Type Rural Health Clinic
Facility Name GILLESPIE RURAL HEALTH CLINIC
Street 807 BROADWAY ST
City GILLESPIE
State IL
ZIP 62033
Phone 217 854-3851
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/4/2025
Certificate Expiration Date 4/3/2027
Facility Type Rural Health Clinic
Lab Director KATE M. EMMERLICH

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