14D0435275 CLIA NUMBER - SHELBYVILLE HEALTHCARE & SENIOR LIVING

Laboratory Demographics

  • CLIA Code: 14D0435275
  • Facility Name: SHELBYVILLE HEALTHCARE & SENIOR LIVING
  • Facility Address: 2116 W SOUTH 3RD & DACEY DR
    SHELBYVILLE, IL
    ZIP 62565
  • Facility Phone: 217 774-2128
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: JENNIFER L. KUGEL
  • NPI Number: 1629222633
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 14D0435275
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name SHELBYVILLE HEALTHCARE & SENIOR LIVING
Street 2116 W SOUTH 3RD & DACEY DR
City SHELBYVILLE
State IL
ZIP 62565
Phone 217 774-2128
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 JENNIFER L. KUGEL

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