14D0433663 CLIA NUMBER - MONTGOMERY COUNTY HEALTH DEPARTMENT

Laboratory Demographics

CLIA Number: 14D0433663

Facility Name: MONTGOMERY COUNTY HEALTH DEPARTMENT

Facility Address:
11191 ILLINOIS ROUTE 185
HILLSBORO, IL
ZIP 62049
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Facility Phone Number: 217 532-2001

Facility Type: Community Clinic

Certificate Type: Waiver

NPI Number: 1528203882

Taxonomy: 261QH0100X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	14D0433663
LAB Type	Community Clinic
Facility Name	MONTGOMERY COUNTY HEALTH DEPARTMENT
Street	11191 ILLINOIS ROUTE 185
City	HILLSBORO
State	IL
ZIP	62049
Phone	217 532-2001
CertificateType	4
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024