14D2289879 CLIA NUMBER - PROMISE HEALTH NFP

Laboratory Demographics

  • CLIA Code: 14D2289879
  • Facility Name: PROMISE HEALTH NFP
  • Facility Address: 424 E WABASH ST
    RANTOUL, IL
    ZIP 61866
  • Facility Phone: 217 356-1558
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Waiver
  • Lab Director: MELONIE M. RICHARDSON
  • NPI Number: 1093571663
  • Taxonomy: 101YM0800X - Counselor

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CLIA Record

Field Name Field Value
CLIA Number 14D2289879
LAB Type Federally Qualified Health Center
Facility Name PROMISE HEALTH NFP
Street 424 E WABASH ST
City RANTOUL
State IL
ZIP 61866
Phone 217 356-1558
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/18/2025
Certificate Expiration Date 9/17/2027
Facility Type Federally Qualified Health Center
Lab Director MELONIE M. RICHARDSON

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