14D2247061 CLIA NUMBER - ALLIED VISION SOURCE MACON COUNTY

Laboratory Demographics

  • CLIA Code: 14D2247061
  • Facility Name: ALLIED VISION SOURCE MACON COUNTY
  • Facility Address: 2475 N MONROE ST
    DECATUR, IL
    ZIP 62526
  • Facility Phone: 217 575-5900
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MATTHEW R. JONES
  • NPI Number: 1861860363
  • Taxonomy: 152W00000X - Optometrist

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CLIA Record

Field Name Field Value
CLIA Number 14D2247061
LAB Type Physician Office
Facility Name ALLIED VISION SOURCE MACON COUNTY
Street 2475 N MONROE ST
City DECATUR
State IL
ZIP 62526
Phone 217 575-5900
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/4/2024
Certificate Expiration Date 1/3/2026
Facility Type Physician Office
Lab Director MATTHEW R. JONES

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