14D2188279 CLIA NUMBER - ADVANCED IMAGING CENTER L L C

Laboratory Demographics

  • CLIA Code: 14D2188279
  • Facility Name: ADVANCED IMAGING CENTER L L C
  • Facility Address: 615 VALLEY VIEW DR - STE 101
    MOLINE, IL
    ZIP 61265
  • Facility Phone: 309 743-0445
  • Facility Type: Independent
  • Facility Type: Waiver
  • Lab Director: CARRIE WILSON
  • NPI Number: 1619964467
  • Taxonomy: 261QR0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D2188279
LAB Type Independent
Facility Name ADVANCED IMAGING CENTER L L C
Street 615 VALLEY VIEW DR - STE 101
City MOLINE
State IL
ZIP 61265
Phone 309 743-0445
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/15/2024
Certificate Expiration Date 7/14/2026
Facility Type Independent
Lab Director CARRIE WILSON

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