14D0044623 CLIA NUMBER - HERITAGE MANOR CARLINVILLE

Laboratory Demographics

  • CLIA Code: 14D0044623
  • Facility Name: HERITAGE MANOR CARLINVILLE
  • Facility Address: 1200 UNIVERSITY AVENUE
    CARLINVILLE, IL
    ZIP 62626
  • Facility Phone: 217 854-4433
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: KARLA SMITH, R N, L N H A
  • NPI Number: 1831180892
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 14D0044623
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name HERITAGE MANOR CARLINVILLE
Street 1200 UNIVERSITY AVENUE
City CARLINVILLE
State IL
ZIP 62626
Phone 217 854-4433
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director KARLA SMITH, R N, L N H A

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