14D2199485 CLIA NUMBER - BLUEZE, LLC

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Laboratory Demographics

CLIA Number: 14D2199485

Facility Name: BLUEZE, LLC

Facility Address:
2412 E WASHINGTON
BLOOMINGTON, IL
ZIP 61704
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Facility Phone Number: 309 585-2116

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1306371299

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	14D2199485
LAB Type	Physician Office
Facility Name	BLUEZE, LLC
Street	2412 E WASHINGTON
City	BLOOMINGTON
State	IL
ZIP	61704
Phone	309 585-2116
CertificateType	4
CertificateEffectiveDate	11/9/2022
CertificateExpirationDate	11/8/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024