14D1055043 CLIA NUMBER - GAILEY EYE SURGERY - DECATUR, L L C

Laboratory Demographics

  • CLIA Code: 14D1055043
  • Facility Name: GAILEY EYE SURGERY - DECATUR, L L C
  • Facility Address: 646 W PERSHING ROAD
    DECATUR, IL
    ZIP 62526
  • Facility Phone: 217 875-2600
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: JODY CRAMER R N
  • NPI Number: 1023056090
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D1055043
LAB Type Ambulatory Surgery Center
Facility Name GAILEY EYE SURGERY - DECATUR, L L C
Street 646 W PERSHING ROAD
City DECATUR
State IL
ZIP 62526
Phone 217 875-2600
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/7/2024
Certificate Expiration Date 6/6/2026
Facility Type Ambulatory Surgery Center
Lab Director JODY CRAMER R N

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