14D2084909 CLIA NUMBER - CHRISTIE CLINIC - ST J

Laboratory Demographics

  • CLIA Code: 14D2084909
  • Facility Name: CHRISTIE CLINIC - ST J
  • Facility Address: 204 N MAIN ST, STE 203
    SAINT JOSEPH, IL
    ZIP 61873
  • Facility Phone: 217 469-2390
  • Facility Type: Other - MULTISPECIALTY CLINIC
  • Facility Type: Waiver
  • Lab Director: JENNIFER WROBLEWSKI
  • NPI Number: 1063093771
  • Taxonomy: 332B00000X - Durable Medical Equipment & Medical Supplies

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 14D2084909
LAB Type Other - MULTISPECIALTY CLINIC
Facility Name CHRISTIE CLINIC - ST J
Street 204 N MAIN ST, STE 203
City SAINT JOSEPH
State IL
ZIP 61873
Phone 217 469-2390
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/15/2025
Certificate Expiration Date 7/14/2027
Facility Type Other - MULTISPECIALTY CLINIC
Lab Director JENNIFER WROBLEWSKI

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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