14D2167693 CLIA NUMBER - RANDOLPH TOWNSHIP FIRE PROTECTION DISTRICT

Laboratory Demographics

  • CLIA Code: 14D2167693
  • Facility Name: RANDOLPH TOWNSHIP FIRE PROTECTION DISTRICT
  • Facility Address: 707 S VINE ST
    HEYWORTH, IL
    ZIP 61745
  • Facility Phone: 309 473-2149
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: JEFFREY KIESLING
  • NPI Number: 1366924888
  • Taxonomy: 3416L0300X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 14D2167693
LAB Type Ambulance
Facility Name RANDOLPH TOWNSHIP FIRE PROTECTION DISTRICT
Street 707 S VINE ST
City HEYWORTH
State IL
ZIP 61745
Phone 309 473-2149
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/13/2025
Certificate Expiration Date 6/12/2027
Facility Type Ambulance
Lab Director JEFFREY KIESLING

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