14D2209090 CLIA NUMBER - ILLINOIS WESLEYAN UNIVERSITY ARNOLD HEALTH SERVICE

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Laboratory Demographics

CLIA Number: 14D2209090

Facility Name: ILLINOIS WESLEYAN UNIVERSITY ARNOLD HEALTH SERVICE

Facility Address:
P O BOX 2900 - MAGILL HALL - LOWER LEVEL ILLINOIS WESLEYAN UNIVERSITY
BLOOMINGTON, IL
ZIP 61701
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Facility Phone Number: 309 556-3107

Facility Type: School/Student Health Service

Certificate Type: Waiver

NPI Number: 1962450734

Taxonomy: 208G00000X - Thoracic Surgery (Cardiothoracic Vascular Surgery)
A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty.

CLIA Record

Field Name	Field Value
CLIA Number	14D2209090
LAB Type	School/Student Health Service
Facility Name	ILLINOIS WESLEYAN UNIVERSITY ARNOLD HEALTH SERVICE
Street	P O BOX 2900 - MAGILL HALL - LOWER LEVEL ILLINOIS WESLEYAN UNIVERSITY
City	BLOOMINGTON
State	IL
ZIP	61701
Phone	309 556-3107
CertificateType	4
CertificateEffectiveDate	1/11/2023
CertificateExpirationDate	1/10/2025
FacilityType	Waiver

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