14D2300148 CLIA NUMBER - FERRELL HOSPITAL FAMILY PRACTICE HARRISBURG

Laboratory Demographics

  • CLIA Code: 14D2300148
  • Facility Name: FERRELL HOSPITAL FAMILY PRACTICE HARRISBURG
  • Facility Address: 30 VETERANS DR
    HARRISBURG, IL
    ZIP 62946
  • Facility Phone: 618 294-8264
  • Facility Type: Rural Health Clinic
  • Facility Type: Microscopy
  • Lab Director: CLAYTON T. FORD
  • NPI Number: 1184202392
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D2300148
LAB Type Rural Health Clinic
Facility Name FERRELL HOSPITAL FAMILY PRACTICE HARRISBURG
Street 30 VETERANS DR
City HARRISBURG
State IL
ZIP 62946
Phone 618 294-8264
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 3/5/2024
Certificate Expiration Date 3/4/2026
Facility Type Rural Health Clinic
Lab Director CLAYTON T. FORD

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