CLIA lab
CLIA 14D2136040: MDH Fam Med/Convenience Care/Surgery/Ent Clinic
Macomb, IL. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 14D2136040 belongs to MDH Fam Med/Convenience Care/Surgery/Ent Clinic in Macomb, IL.
Certificate of Waiver, effective August 31, 2025, expires August 30, 2027.
Active in the CMS Provider of Services file posted October 16, 2026.
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
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Certificate
- Certificate type
- Certificate of Waiver
- Certificate effective
- August 31, 2025
- Certificate expiration
- August 30, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- August 31, 2017
- Facility type
- Physician office
- Ownership (control type)
- Government, county
- Lab classification
- CLIA laboratory
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 14D2136040
- Lab name
- MDH Fam Med/Convenience Care/Surgery/Ent Clinic
- Address
- 515 E Grant, Stes 112, 113, 211, 213, Macomb, IL 61455
- Phone
- (309) 837-6937
- Fax
- (309) 837-1979
Annual test volume the lab reported
- Waived tests
- 1,000
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
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Related
Questions
What is the CLIA number for MDH Fam Med/Convenience Care/Surgery/Ent Clinic in Macomb?
14D2136040, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does MDH Fam Med/Convenience Care/Surgery/Ent Clinic hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 14D2136040 expire?
The CMS file lists August 30, 2027 as the certificate expiration date; the certificate took effect August 31, 2025.