14D2127357 CLIA NUMBER - CARMI FAMILY MEDICINE

Laboratory Demographics

CLIA Number: 14D2127357

Facility Name: CARMI FAMILY MEDICINE

Facility Address:
1388 IL HIGHWAY 1
CARMI, IL
ZIP 62821
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Facility Phone Number: 618 380-9321

Facility Type: Rural Health Clinic

Certificate Type: Microscopy

NPI Number: 1134650997

Taxonomy: 261QR1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	14D2127357
LAB Type	Rural Health Clinic
Facility Name	CARMI FAMILY MEDICINE
Street	1388 IL HIGHWAY 1
City	CARMI
State	IL
ZIP	62821
Phone	618 380-9321
CertificateType	3
CertificateEffectiveDate	7/23/2023
CertificateExpirationDate	7/22/2025
FacilityType	PPMP

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This page was last updated on: 4/23/2024