14D2315791 CLIA NUMBER - GERIO PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 14D2315791
  • Facility Name: GERIO PRIMARY CARE
  • Facility Address: 556 N 2ND ST
    BREESE, IL
    ZIP 62230
  • Facility Phone: 618 484-9030
  • Facility Type: Rural Health Clinic
  • Facility Type: Waiver
  • Lab Director: KIMBERLY A. BROMLEY
  • NPI Number: 1700578846
  • Taxonomy: 207QG0300X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D2315791
LAB Type Rural Health Clinic
Facility Name GERIO PRIMARY CARE
Street 556 N 2ND ST
City BREESE
State IL
ZIP 62230
Phone 618 484-9030
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/19/2024
Certificate Expiration Date 12/18/2026
Facility Type Rural Health Clinic
Lab Director KIMBERLY A. BROMLEY

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