14D2328882 CLIA NUMBER - FERRELL HOSPITAL HARRISBURG SMALL STREET CLINIC

Laboratory Demographics

  • CLIA Code: 14D2328882
  • Facility Name: FERRELL HOSPITAL HARRISBURG SMALL STREET CLINIC
  • Facility Address: 250 SMALL ST
    HARRISBURG, IL
    ZIP 62946
  • Facility Phone: 618 294-8264
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: CLAYTON T. FORD
  • NPI Number: 1124905351
  • Taxonomy: 261QM1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D2328882
LAB Type Physician Office
Facility Name FERRELL HOSPITAL HARRISBURG SMALL STREET CLINIC
Street 250 SMALL ST
City HARRISBURG
State IL
ZIP 62946
Phone 618 294-8264
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 8/19/2025
Certificate Expiration Date 8/18/2027
Facility Type Physician Office
Lab Director CLAYTON T. FORD

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