16D2325651 CLIA NUMBER - CENTRAL ILLINOIS PREVENTIVE SERVICES

Laboratory Demographics

  • CLIA Code: 16D2325651
  • Facility Name: CENTRAL ILLINOIS PREVENTIVE SERVICES
  • Facility Address: 5359 EASTERN AVE
    DAVENPORT, IA
    ZIP 52807
  • Facility Phone: 563 306-2660
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ANDREW CARAVELLO
  • NPI Number: 1326850587
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 16D2325651
LAB Type Physician Office
Facility Name CENTRAL ILLINOIS PREVENTIVE SERVICES
Street 5359 EASTERN AVE
City DAVENPORT
State IA
ZIP 52807
Phone 563 306-2660
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/17/2025
Certificate Expiration Date 6/16/2027
Facility Type Physician Office
Lab Director ANDREW CARAVELLO

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