14D2121447 CLIA NUMBER - AIR EVAC LIFETEAM AEL 137

Laboratory Demographics

  • CLIA Code: 14D2121447
  • Facility Name: AIR EVAC LIFETEAM AEL 137
  • Facility Address: 635 ILLINOIS ROUTE 127
    GREENVILLE, IL
    ZIP 62246
  • Facility Phone: 618 306-4198
  • Facility Type: Mobile Laboratory
  • Facility Type: Waiver
  • Lab Director: BRIAN MARTINEZ
  • NPI Number: 1225585904
  • Taxonomy: 3416A0800X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 14D2121447
LAB Type Mobile Laboratory
Facility Name AIR EVAC LIFETEAM AEL 137
Street 635 ILLINOIS ROUTE 127
City GREENVILLE
State IL
ZIP 62246
Phone 618 306-4198
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/4/2024
Certificate Expiration Date 11/3/2026
Facility Type Mobile Laboratory
Lab Director BRIAN MARTINEZ

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