14D2266349 CLIA NUMBER - MYCARE EXPRESS CARE INC

Laboratory Demographics

  • CLIA Code: 14D2266349
  • Facility Name: MYCARE EXPRESS CARE INC
  • Facility Address: 1404 EASTLAND DR - STE 103
    BLOOMINGTON, IL
    ZIP 61701
  • Facility Phone: 309 319-2393
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JIBRAN NASEER
  • NPI Number: 1396464657
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 14D2266349
LAB Type Physician Office
Facility Name MYCARE EXPRESS CARE INC
Street 1404 EASTLAND DR - STE 103
City BLOOMINGTON
State IL
ZIP 61701
Phone 309 319-2393
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/9/2024
Certificate Expiration Date 8/8/2026
Facility Type Physician Office
Lab Director JIBRAN NASEER

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