14D2147347 CLIA NUMBER - AIR EVAC LIFETEAM - 145 MATTOON IL

Laboratory Demographics

  • CLIA Code: 14D2147347
  • Facility Name: AIR EVAC LIFETEAM - 145 MATTOON IL
  • Facility Address: 7849 N COUNTY RD 1050 E
    MATTOON, IL
    ZIP 61938
  • Facility Phone: 217 208-7630
  • Facility Type: Mobile Laboratory
  • Facility Type: Waiver
  • Lab Director: MEGAN KELLY
  • NPI Number: 1124555693
  • Taxonomy: 3416A0800X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 14D2147347
LAB Type Mobile Laboratory
Facility Name AIR EVAC LIFETEAM - 145 MATTOON IL
Street 7849 N COUNTY RD 1050 E
City MATTOON
State IL
ZIP 61938
Phone 217 208-7630
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 MEGAN KELLY

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