14D2215025 CLIA NUMBER - NORTH BOONE COMMUNITY UNIT SCHOOL DISTRICT 200

Laboratory Demographics

CLIA Number: 14D2215025

Facility Name: NORTH BOONE COMMUNITY UNIT SCHOOL DISTRICT 200

Facility Address:
6248 N BOONE SCHOOL RD
POPLAR GROVE, IL
ZIP 61065
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Facility Phone Number: 815 765-3322

Facility Type: School/Student Health Service

Certificate Type: Waiver

NPI Number: 1164810255

Taxonomy: 341600000X - Ambulance
An emergency vehicle used for transporting patients to a health care facility after injury or illness. Types of ambulances used in the United States include ground (surface) ambulance, rotor-wing (helicopter), and fixed-wing aircraft (airplane).

CLIA Record

Field Name	Field Value
CLIA Number	14D2215025
LAB Type	School/Student Health Service
Facility Name	NORTH BOONE COMMUNITY UNIT SCHOOL DISTRICT 200
Street	6248 N BOONE SCHOOL RD
City	POPLAR GROVE
State	IL
ZIP	61065
Phone	815 765-3322
CertificateType	4
CertificateEffectiveDate	2/26/2023
CertificateExpirationDate	2/25/2025
FacilityType	Waiver

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