14D2120769 CLIA NUMBER - MEMORIAL MEDICAL CLINIC COLCHESTER

Laboratory Demographics

  • CLIA Code: 14D2120769
  • Facility Name: MEMORIAL MEDICAL CLINIC COLCHESTER
  • Facility Address: 110 E MARKET ST
    COLCHESTER, IL
    ZIP 62326
  • Facility Phone: 309 776-3301
  • Facility Type: Rural Health Clinic
  • Facility Type: Waiver
  • Lab Director: DOUGLAS HEIGHTON MD
  • NPI Number: 1699228882
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D2120769
LAB Type Rural Health Clinic
Facility Name MEMORIAL MEDICAL CLINIC COLCHESTER
Street 110 E MARKET ST
City COLCHESTER
State IL
ZIP 62326
Phone 309 776-3301
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/24/2024
Certificate Expiration Date 10/23/2026
Facility Type Rural Health Clinic
Lab Director DOUGLAS HEIGHTON MD

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