14D1070473 CLIA NUMBER - WABASH GENERAL CONVENIENT CARE CLINIC WABASH GENERAL HOSPITAL

Laboratory Demographics

  • CLIA Code: 14D1070473
  • Facility Name: WABASH GENERAL CONVENIENT CARE CLINIC WABASH GENERAL HOSPITAL
  • Facility Address: 1418 COLLEGE DRIVE
    MOUNT CARMEL, IL
    ZIP 62863
  • Facility Phone: 618 262-8621
  • Facility Type: Rural Health Clinic
  • Facility Type: Waiver
  • Lab Director: EMILY KRAJEC
  • NPI Number: 1578012084
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D1070473
LAB Type Rural Health Clinic
Facility Name WABASH GENERAL CONVENIENT CARE CLINIC WABASH GENERAL HOSPITAL
Street 1418 COLLEGE DRIVE
City MOUNT CARMEL
State IL
ZIP 62863
Phone 618 262-8621
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/29/2025
Certificate Expiration Date 6/28/2027
Facility Type Rural Health Clinic
Lab Director EMILY KRAJEC

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