14D2110284 CLIA NUMBER - CLAY COUNTY HOSPITAL CLAY CITY MED CLINIC

Laboratory Demographics

  • CLIA Code: 14D2110284
  • Facility Name: CLAY COUNTY HOSPITAL CLAY CITY MED CLINIC
  • Facility Address: 939 SUNSET RD SW
    CLAY CITY, IL
    ZIP 62824
  • Facility Phone: 618 662-2131
  • Facility Type: Rural Health Clinic
  • Facility Type: Waiver
  • Lab Director: JASON JERABEK DO
  • NPI Number: 1396188264
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2110284
LAB Type Rural Health Clinic
Facility Name CLAY COUNTY HOSPITAL CLAY CITY MED CLINIC
Street 939 SUNSET RD SW
City CLAY CITY
State IL
ZIP 62824
Phone 618 662-2131
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/11/2024
Certificate Expiration Date 3/10/2026
Facility Type Rural Health Clinic
Lab Director JASON JERABEK DO

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