14D2090508 CLIA NUMBER - BRIDGEWAY INC

Laboratory Demographics

  • CLIA Code: 14D2090508
  • Facility Name: BRIDGEWAY INC
  • Facility Address: 2323 WINDISH DR
    GALESBURG, IL
    ZIP 61401
  • Facility Phone: 309 344-2323
  • Facility Type: Other - OTPT SUBSTANCE ABUSE TRMT
  • Facility Type: Waiver
  • Lab Director: STACY BROWN
  • NPI Number: 1861776213
  • Taxonomy: 251S00000X - Community/Behavioral Health

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CLIA Record

Field Name Field Value
CLIA Number 14D2090508
LAB Type Other - OTPT SUBSTANCE ABUSE TRMT
Facility Name BRIDGEWAY INC
Street 2323 WINDISH DR
City GALESBURG
State IL
ZIP 61401
Phone 309 344-2323
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/26/2025
Certificate Expiration Date 1/25/2027
Facility Type Other - OTPT SUBSTANCE ABUSE TRMT
Lab Director STACY BROWN

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