14D0044875 CLIA NUMBER - PASSAVANT AREA HOSPITAL

Laboratory Demographics

  • CLIA Code: 14D0044875
  • Facility Name: PASSAVANT AREA HOSPITAL
  • Facility Address: 1600 W WALNUT ST
    JACKSONVILLE, IL
    ZIP 62650
  • Facility Phone: 217 245-9541
  • Facility Type: Hospital
  • Facility Type: Accreditation
  • Lab Director: DR. JOHN Z. GAO
  • NPI Number: 1174580831
  • Taxonomy: 282NC0060X - General Acute Care Hospital

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CLIA Record

Field Name Field Value
CLIA Number 14D0044875
LAB Type Hospital
Facility Name PASSAVANT AREA HOSPITAL
Street 1600 W WALNUT ST
City JACKSONVILLE
State IL
ZIP 62650
Phone 217 245-9541
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 2/28/2025
Certificate Expiration Date 2/27/2027
Facility Type Hospital
Lab Director DR. JOHN Z. GAO

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This page was last updated on: 6/4/2025