14D2176023 CLIA NUMBER - SWANSON FAMILY PRACTICE, PLLC

Laboratory Demographics

  • CLIA Code: 14D2176023
  • Facility Name: SWANSON FAMILY PRACTICE, PLLC
  • Facility Address: 723 N LOGAN AVE
    DANVILLE, IL
    ZIP 61832
  • Facility Phone: 217 213-5808
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DINA G. SWANSON
  • NPI Number: 1104461870
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D2176023
LAB Type Physician Office
Facility Name SWANSON FAMILY PRACTICE, PLLC
Street 723 N LOGAN AVE
City DANVILLE
State IL
ZIP 61832
Phone 217 213-5808
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/6/2023
Certificate Expiration Date 12/5/2025
Facility Type Physician Office
Lab Director DINA G. SWANSON

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