14D2240811 CLIA NUMBER - JACKSON COUNTY AMBULANCE SERVICE

Laboratory Demographics

  • CLIA Code: 14D2240811
  • Facility Name: JACKSON COUNTY AMBULANCE SERVICE
  • Facility Address: 520 N UNIVERSITY AVE
    CARBONDALE, IL
    ZIP 62901
  • Facility Phone: 618 529-5158
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: KENTON J. SCHAFER
  • NPI Number: 1437260528
  • Taxonomy: 3416L0300X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 14D2240811
LAB Type Ambulance
Facility Name JACKSON COUNTY AMBULANCE SERVICE
Street 520 N UNIVERSITY AVE
City CARBONDALE
State IL
ZIP 62901
Phone 618 529-5158
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/22/2025
Certificate Expiration Date 10/21/2027
Facility Type Ambulance
Lab Director KENTON J. SCHAFER

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