14D2121738 CLIA NUMBER - ANGEL CARE CENTER LLC

Laboratory Demographics

  • CLIA Code: 14D2121738
  • Facility Name: ANGEL CARE CENTER LLC
  • Facility Address: 3405 OFFICE PARK DR - STE B
    MARION, IL
    ZIP 62959
  • Facility Phone: 618 997-8412
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: KEVIN C. CHEN
  • NPI Number: 1750837043
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D2121738
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name ANGEL CARE CENTER LLC
Street 3405 OFFICE PARK DR - STE B
City MARION
State IL
ZIP 62959
Phone 618 997-8412
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/14/2024
Certificate Expiration Date 11/13/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director KEVIN C. CHEN

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