14D2329601 CLIA NUMBER - RANCHERO CLINIC

Laboratory Demographics

  • CLIA Code: 14D2329601
  • Facility Name: RANCHERO CLINIC
  • Facility Address: 825 18TH ST - STE 238
    CHARLESTON, IL
    ZIP 61920
  • Facility Phone: 217 500-5484
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BERNIE C. RANCHERO
  • NPI Number: 1457245029
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D2329601
LAB Type Physician Office
Facility Name RANCHERO CLINIC
Street 825 18TH ST - STE 238
City CHARLESTON
State IL
ZIP 61920
Phone 217 500-5484
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/2/2025
Certificate Expiration Date 9/1/2027
Facility Type Physician Office
Lab Director BERNIE C. RANCHERO

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