14D0434027 CLIA NUMBER - ST PAUL'S HOME FOR THE AGED

Laboratory Demographics

  • CLIA Code: 14D0434027
  • Facility Name: ST PAUL'S HOME FOR THE AGED
  • Facility Address: 1021 WEST E STREET
    BELLEVILLE, IL
    ZIP 62220
  • Facility Phone: 618 233-2095
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: PAM WOODWARD
  • NPI Number: 1710973284
  • Taxonomy: 313M00000X - Nursing Facility/Intermediate Care Facility

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CLIA Record

Field Name Field Value
CLIA Number 14D0434027
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name ST PAUL'S HOME FOR THE AGED
Street 1021 WEST E STREET
City BELLEVILLE
State IL
ZIP 62220
Phone 618 233-2095
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/11/2025
Certificate Expiration Date 7/10/2027
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director PAM WOODWARD

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