14D2277265 CLIA NUMBER - DEACONESS ILLINOIS CLINIC DEACONESS ILLINOIS CLINIC

Laboratory Demographics

  • CLIA Code: 14D2277265
  • Facility Name: DEACONESS ILLINOIS CLINIC DEACONESS ILLINOIS CLINIC
  • Facility Address: 303 COMMERICAL ST
    HARRISBURG, IL
    ZIP 62946
  • Facility Phone: (618) 918-6060
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JODI BRYANT
  • NPI Number: 1285350504
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D2277265
LAB Type Physician Office
Facility Name DEACONESS ILLINOIS CLINIC DEACONESS ILLINOIS CLINIC
Street 303 COMMERICAL ST
City HARRISBURG
State IL
ZIP 62946
Phone 6189186060
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/23/2025
Certificate Expiration Date 2/22/2027
Facility Type Physician Office
Lab Director JODI BRYANT

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This page was last updated on: 5/18/2026