14D2147736 CLIA NUMBER - BLESSING EMPLOYER CLINIC

Laboratory Demographics

  • CLIA Code: 14D2147736
  • Facility Name: BLESSING EMPLOYER CLINIC
  • Facility Address: 326 N 24TH ST
    QUINCY, IL
    ZIP 62301
  • Facility Phone: 217 223-8400
  • Facility Type: Rural Health Clinic
  • Facility Type: Waiver
  • Lab Director: SURYA POLAVARAPU
  • NPI Number: 1407449259
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D2147736
LAB Type Rural Health Clinic
Facility Name BLESSING EMPLOYER CLINIC
Street 326 N 24TH ST
City QUINCY
State IL
ZIP 62301
Phone 217 223-8400
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/25/2024
Certificate Expiration Date 4/24/2026
Facility Type Rural Health Clinic
Lab Director SURYA POLAVARAPU

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