14D0435277 CLIA NUMBER - SHELBY COUNTY HEALTH DEPT

Laboratory Demographics

CLIA Number: 14D0435277

Facility Name: SHELBY COUNTY HEALTH DEPT

Facility Address:
1700 WEST SOUTH 3RD STREET
SHELBYVILLE, IL
ZIP 62565
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Facility Phone Number: 217 774-9555

Facility Type: Other

Certificate Type: Waiver

NPI Number: 1528042686

Taxonomy: 251K00000X - Public Health or Welfare

CLIA Record

Field Name	Field Value
CLIA Number	14D0435277
LAB Type	Other
Facility Name	SHELBY COUNTY HEALTH DEPT
Street	1700 WEST SOUTH 3RD STREET
City	SHELBYVILLE
State	IL
ZIP	62565
Phone	217 774-9555
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