14D0434960 CLIA NUMBER - VANDALIA HEALTH CARE & SENIOR LIVING

Laboratory Demographics

  • CLIA Code: 14D0434960
  • Facility Name: VANDALIA HEALTH CARE & SENIOR LIVING
  • Facility Address: 1500 W ST LOUIS AVE
    VANDALIA, IL
    ZIP 62471
  • Facility Phone: 618 283-4262
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: MELISSA A. WILLMS
  • NPI Number: 1083868095
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 14D0434960
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name VANDALIA HEALTH CARE & SENIOR LIVING
Street 1500 W ST LOUIS AVE
City VANDALIA
State IL
ZIP 62471
Phone 618 283-4262
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 MELISSA A. WILLMS

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