14D2070993 CLIA NUMBER - COMWELL

Laboratory Demographics

  • CLIA Code: 14D2070993
  • Facility Name: COMWELL
  • Facility Address: 10257 STATE ROUTE 3
    RED BUD, IL
    ZIP 62278
  • Facility Phone: 618 282-6233
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: GARY L. BUATTE
  • NPI Number: 1356563563
  • Taxonomy: 261QR0405X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D2070993
LAB Type Community Clinic
Facility Name COMWELL
Street 10257 STATE ROUTE 3
City RED BUD
State IL
ZIP 62278
Phone 618 282-6233
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/31/2023
Certificate Expiration Date 12/30/2025
Facility Type Community Clinic
Lab Director GARY L. BUATTE

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