14D2319730 CLIA NUMBER - GRAHAM HOSPITAL ASSOCIATION LABORATORY

Laboratory Demographics

  • CLIA Code: 14D2319730
  • Facility Name: GRAHAM HOSPITAL ASSOCIATION LABORATORY
  • Facility Address: 180 S MAIN ST
    CANTON, IL
    ZIP 61520
  • Facility Phone: 309 647-5240
  • Facility Type: Hospital
  • Facility Type: Waiver
  • Lab Director: RONALD CHAMPAGNE
  • NPI Number: 1093288797
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D2319730
LAB Type Hospital
Facility Name GRAHAM HOSPITAL ASSOCIATION LABORATORY
Street 180 S MAIN ST
City CANTON
State IL
ZIP 61520
Phone 309 647-5240
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/6/2025
Certificate Expiration Date 3/5/2027
Facility Type Hospital
Lab Director RONALD CHAMPAGNE

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