14D1049387 CLIA NUMBER - MILAN MEDICAL GROUP

Laboratory Demographics

CLIA Number: 14D1049387

Facility Name: MILAN MEDICAL GROUP

Facility Address:
1929 E 10TH AVE
MILAN, IL
ZIP 61264
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Facility Phone Number: 309 787-2600

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1346362589

Taxonomy: 208D00000X - General Practice
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

CLIA Record

Field Name	Field Value
CLIA Number	14D1049387
LAB Type	Physician Office
Facility Name	MILAN MEDICAL GROUP
Street	1929 E 10TH AVE
City	MILAN
State	IL
ZIP	61264
Phone	309 787-2600
CertificateType	4
CertificateEffectiveDate	1/4/2024
CertificateExpirationDate	1/3/2026
FacilityType	Waiver

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