GIBSON CITY CLINIC SC
NPI 1386903946
Clinic/Center in Gibson City, IL

Active since May 16, 2012CLIA 14D0429411 · Microscopy
222 N SANGAMON AVE, GIBSON CITY, IL 60936(217) 784-8148(217) 784-8160 Get Directions Write a Review

NPPES record last updated: May 16, 2012. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Gibson City Clinic Sc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GIBSON CITY CLINIC SC (NPI 1386903946) is a healthcare organization registered as a clinic/center in Gibson City, Illinois and active in the NPI registry since May 2012. The organization holds a CLIA Microscopy certificate valid through August 31, 2026 and lists David Hagan, President, as its authorized official.

NPPES Registry Identity

NPI1386903946
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NameGIBSON CITY CLINIC SC
Location Address222 N SANGAMON AVEGibson City, IL 60936-1345
Mailing Address222 N Sangamon AveGibson City, IL 60936-1345 · (217) 784-8148 · Fax (217) 784-8160
Fax(217) 784-8160
Organization SubpartNo
Authorized OfficialDavid HaganPresident · (217) 784-8148
Enumeration DateMay 16, 2012
NPI 1386903946 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities
Taxonomy Code261Q00000X
License Licensed in IL · 036-066538
Definition

A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

222 N SANGAMON AVE, Gibson City, IL 60936

Other Identifiers 1

Medicaid=========-60936-02IL

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 14D0429411

Gibson City Clinic Sc · Gibson City, IL
Active · expires Aug 31, 2026
CLIA Number14D0429411
Laboratory TypePhysician Office
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorDavid J. Hagan
Laboratory Phone(217) 784-8148
Laboratory LocationGibson City Clinic Sc222 North Sangamon, Gibson City, IL 60936
CLIA data matches this NPI record on: Address Name Phone
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.

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Family Medicine
222 N SANGAMON AVE
GIBSON CITY, IL 60936
Licensed Practical Nurse
222 N SANGAMON AVE
GIBSON CITY, IL 60936
Family Medicine
222 N SANGAMON AVE
GIBSON CITY, IL 60936
Registered Nurse
222 N SANGAMON AVE, GIBSON CITY CLINIC SC
GIBSON CITY, IL 60936
Registered Nurse
222 N SANGAMON AVE
GIBSON CITY, IL 60936
Nurse Practitioner (Family)
222 N SANGAMON AVE
GIBSON CITY, IL 60936
Registered Nurse
222 N SANGAMON AVE
GIBSON CITY, IL 60936
Clinic/Center (Rural Health)
222 N SANGAMON AVE
GIBSON CITY, IL 60936

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Gibson City Clinic Sc's NPI number?

The NPI number for Gibson City Clinic Sc is 1386903946. It was assigned to this organization in the NPPES registry on May 16, 2012.

Where is Gibson City Clinic Sc located?

Gibson City Clinic Sc is located at 222 N Sangamon Ave, Gibson City, IL 60936. The listed phone number is (217) 784-8148.

What is Gibson City Clinic Sc's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

Does Gibson City Clinic Sc hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 14D0429411) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Gibson City Clinic Sc was last updated on May 16, 2012. NPI Profile syncs with the weekly NPPES data releases published by CMS.