14D2126598 CLIA NUMBER - MANITO MEDICAL ASSOCIATES

Laboratory Demographics

  • CLIA Code: 14D2126598
  • Facility Name: MANITO MEDICAL ASSOCIATES
  • Facility Address: 1301 S EAST AVE
    MANITO, IL
    ZIP 61546
  • Facility Phone: 309 968-5311
  • Facility Type: Rural Health Clinic
  • Facility Type: Waiver
  • Lab Director: MICHAEL MARKLEY
  • NPI Number: 1780128512
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D2126598
LAB Type Rural Health Clinic
Facility Name MANITO MEDICAL ASSOCIATES
Street 1301 S EAST AVE
City MANITO
State IL
ZIP 61546
Phone 309 968-5311
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/1/2025
Certificate Expiration Date 2/28/2027
Facility Type Rural Health Clinic
Lab Director MICHAEL MARKLEY

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