14D2167509 CLIA NUMBER - HAVEN HOSPICE I L, L L C

Laboratory Demographics

  • CLIA Code: 14D2167509
  • Facility Name: HAVEN HOSPICE I L, L L C
  • Facility Address: 1318 N MICHIGAN AVE
    MARSHALL, IL
    ZIP 62441
  • Facility Phone: (847) 515-1505
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: DARRIN M. RAY
  • NPI Number: 1790247906
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 14D2167509
LAB Type Hospice
Facility Name HAVEN HOSPICE I L, L L C
Street 1318 N MICHIGAN AVE
City MARSHALL
State IL
ZIP 62441
Phone 8475151505
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/10/2025
Certificate Expiration Date 6/9/2027
Facility Type Hospice
Lab Director DARRIN M. RAY

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This page was last updated on: 5/18/2026