14D2155696 CLIA NUMBER - CENTRAL ILLINOIS CENTER FOR WELLNESS

Laboratory Demographics

  • CLIA Code: 14D2155696
  • Facility Name: CENTRAL ILLINOIS CENTER FOR WELLNESS
  • Facility Address: 2501 E COLLEGE AVE - STE C
    BLOOMINGTON, IL
    ZIP 61704
  • Facility Phone: 309 807-5356
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: WILLIAM J. RAY
  • NPI Number: 1104391739
  • Taxonomy: 261QP2300X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 14D2155696
LAB Type Physician Office
Facility Name CENTRAL ILLINOIS CENTER FOR WELLNESS
Street 2501 E COLLEGE AVE - STE C
City BLOOMINGTON
State IL
ZIP 61704
Phone 309 807-5356
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/3/2024
Certificate Expiration Date 10/2/2026
Facility Type Physician Office
Lab Director WILLIAM J. RAY

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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