14D2300889 CLIA NUMBER - MIDWEST MEDICAL CENTER

Laboratory Demographics

  • CLIA Code: 14D2300889
  • Facility Name: MIDWEST MEDICAL CENTER
  • Facility Address: ONE MEDICAL CENTER DR - SPECIALTY CLINIC
    GALENA, IL
    ZIP 61036
  • Facility Phone: 815 777-2426
  • Facility Type: Rural Health Clinic
  • Facility Type: Microscopy
  • Lab Director: PETER M. COLEGROVE
  • NPI Number: 1952409765
  • Taxonomy: 282NC0060X - General Acute Care Hospital

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CLIA Record

Field Name Field Value
CLIA Number 14D2300889
LAB Type Rural Health Clinic
Facility Name MIDWEST MEDICAL CENTER
Street ONE MEDICAL CENTER DR - SPECIALTY CLINIC
City GALENA
State IL
ZIP 61036
Phone 815 777-2426
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 3/18/2024
Certificate Expiration Date 3/17/2026
Facility Type Rural Health Clinic
Lab Director PETER M. COLEGROVE

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