14D2013023 CLIA NUMBER - FERRELL HOSPITAL FAMILY PRACTICE - ELDORADO D/B/A FERRELL HOSPITAL COMMUNITY FOUNDATION

Laboratory Demographics

  • CLIA Code: 14D2013023
  • Facility Name: FERRELL HOSPITAL FAMILY PRACTICE - ELDORADO D/B/A FERRELL HOSPITAL COMMUNITY FOUNDATION
  • Facility Address: 1306 MAPLE ST
    ELDORADO, IL
    ZIP 62930
  • Facility Phone: (618) 297-9665
  • Facility Type: Rural Health Clinic
  • Facility Type: Waiver
  • Lab Director: NATHAN E. OLDHAM
  • NPI Number: 1457586620
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D2013023
LAB Type Rural Health Clinic
Facility Name FERRELL HOSPITAL FAMILY PRACTICE - ELDORADO D/B/A FERRELL HOSPITAL COMMUNITY FOUNDATION
Street 1306 MAPLE ST
City ELDORADO
State IL
ZIP 62930
Phone 6182979665
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/14/2024
Certificate Expiration Date 9/13/2026
Facility Type Rural Health Clinic
Lab Director NATHAN E. OLDHAM

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This page was last updated on: 5/18/2026