14D2147345 CLIA NUMBER - AIR EVAC LIFETEAM - AEL 150 OLNEY IL

Laboratory Demographics

  • CLIA Code: 14D2147345
  • Facility Name: AIR EVAC LIFETEAM - AEL 150 OLNEY IL
  • Facility Address: 3666 N IL 130
    OLNEY, IL
    ZIP 62450
  • Facility Phone: 812 213-6208
  • Facility Type: Mobile Laboratory
  • Facility Type: Waiver
  • Lab Director: THOMAS ALLEN
  • NPI Number: 1104338425
  • Taxonomy: 3416A0800X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 14D2147345
LAB Type Mobile Laboratory
Facility Name AIR EVAC LIFETEAM - AEL 150 OLNEY IL
Street 3666 N IL 130
City OLNEY
State IL
ZIP 62450
Phone 812 213-6208
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/17/2024
Certificate Expiration Date 4/16/2026
Facility Type Mobile Laboratory
Lab Director THOMAS ALLEN

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