14D1088061 CLIA NUMBER - AIR EVAC 28 AIR EVAC EMS INC

Laboratory Demographics

CLIA Number: 14D1088061

Facility Name: AIR EVAC 28 AIR EVAC EMS INC

Facility Address:
6945 N US HWY 45
WATSON, IL
ZIP 62473
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Facility Phone Number: 217 536-9341

Facility Type: Ambulance

Certificate Type: Waiver

NPI Number: 1467435461

Taxonomy: 3416A0800X - Ambulance

CLIA Record

Field Name	Field Value
CLIA Number	14D1088061
LAB Type	Ambulance
Facility Name	AIR EVAC 28 AIR EVAC EMS INC
Street	6945 N US HWY 45
City	WATSON
State	IL
ZIP	62473
Phone	217 536-9341
CertificateType	4
CertificateEffectiveDate	8/15/2022
CertificateExpirationDate	8/14/2024
FacilityType	Waiver

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