14D2311611 CLIA NUMBER - CENTRAL ILLINOIS URGENT CARE

Laboratory Demographics

  • CLIA Code: 14D2311611
  • Facility Name: CENTRAL ILLINOIS URGENT CARE
  • Facility Address: 1019 CHARLESTON AVE E
    MATTOON, IL
    ZIP 61938
  • Facility Phone: 217 994-9301
  • Facility Type: Other - URGENT CARE
  • Facility Type: Waiver
  • Lab Director: PAUL A. TOOFAN
  • NPI Number: 1124246939
  • Taxonomy: 225100000X - Physical Therapist

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CLIA Record

Field Name Field Value
CLIA Number 14D2311611
LAB Type Other - URGENT CARE
Facility Name CENTRAL ILLINOIS URGENT CARE
Street 1019 CHARLESTON AVE E
City MATTOON
State IL
ZIP 61938
Phone 217 994-9301
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/25/2024
Certificate Expiration Date 9/24/2026
Facility Type Other - URGENT CARE
Lab Director PAUL A. TOOFAN

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