14D1088066 CLIA NUMBER - AIR EVAC 5 AIR EVAC EMS INC

Laboratory Demographics

  • CLIA Code: 14D1088066
  • Facility Name: AIR EVAC 5 AIR EVAC EMS INC
  • Facility Address: 1015 BROADWAY ST
    QUINCY, IL
    ZIP 62301
  • Facility Phone: 217 222-9632
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: BRANDON BUCKMAN
  • NPI Number: 1407839202
  • Taxonomy: 3416A0800X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 14D1088066
LAB Type Ambulance
Facility Name AIR EVAC 5 AIR EVAC EMS INC
Street 1015 BROADWAY ST
City QUINCY
State IL
ZIP 62301
Phone 217 222-9632
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/15/2024
Certificate Expiration Date 8/14/2026
Facility Type Ambulance
Lab Director BRANDON BUCKMAN

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