14D2322108 CLIA NUMBER - MILLIKIN UNIVERSITY HEALTH CLINIC

Laboratory Demographics

  • CLIA Code: 14D2322108
  • Facility Name: MILLIKIN UNIVERSITY HEALTH CLINIC
  • Facility Address: 150 S FAIRVIEW AVE
    DECATUR, IL
    ZIP 62522
  • Facility Phone: 217 424-6360
  • Facility Type: School/Student Health Service
  • Facility Type: Waiver
  • Lab Director: KELLY SLADE
  • NPI Number: 1164176863
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D2322108
LAB Type School/Student Health Service
Facility Name MILLIKIN UNIVERSITY HEALTH CLINIC
Street 150 S FAIRVIEW AVE
City DECATUR
State IL
ZIP 62522
Phone 217 424-6360
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/15/2025
Certificate Expiration Date 4/14/2027
Facility Type School/Student Health Service
Lab Director KELLY SLADE

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