14D2063808 CLIA NUMBER - QUINCY MEDICAL GROUP - QUINCY UNIVERSITY

Laboratory Demographics

  • CLIA Code: 14D2063808
  • Facility Name: QUINCY MEDICAL GROUP - QUINCY UNIVERSITY
  • Facility Address: 1800 COLLEGE AVE 113 FRIAR'S HALL QUINCY UNIVERSITY
    QUINCY, IL
    ZIP 62301
  • Facility Phone: 217 228-5432
  • Facility Type: Rural Health Clinic
  • Facility Type: Waiver
  • Lab Director: RICHARD NOBLE
  • NPI Number: 1770614570
  • Taxonomy: 291U00000X - Clinical Medical Laboratory

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CLIA Record

Field Name Field Value
CLIA Number 14D2063808
LAB Type Rural Health Clinic
Facility Name QUINCY MEDICAL GROUP - QUINCY UNIVERSITY
Street 1800 COLLEGE AVE 113 FRIAR'S HALL QUINCY UNIVERSITY
City QUINCY
State IL
ZIP 62301
Phone 217 228-5432
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/2/2023
Certificate Expiration Date 11/1/2025
Facility Type Rural Health Clinic
Lab Director RICHARD NOBLE

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