14D2196077 CLIA NUMBER - GRAHAM MEDICAL GROUP

Laboratory Demographics

  • CLIA Code: 14D2196077
  • Facility Name: GRAHAM MEDICAL GROUP
  • Facility Address: 120 E GALE
    WILLIAMSFIELD, IL
    ZIP 61489
  • Facility Phone: 309 634-4004
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: JASON G. CHAMBERLIN
  • NPI Number: 1508463563
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D2196077
LAB Type Community Clinic
Facility Name GRAHAM MEDICAL GROUP
Street 120 E GALE
City WILLIAMSFIELD
State IL
ZIP 61489
Phone 309 634-4004
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/14/2024
Certificate Expiration Date 10/13/2026
Facility Type Community Clinic
Lab Director JASON G. CHAMBERLIN

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