14D0646839 CLIA NUMBER - LIVINGSTON COUNTY HEALTH DEPARTMENT

Laboratory Demographics

  • CLIA Code: 14D0646839
  • Facility Name: LIVINGSTON COUNTY HEALTH DEPARTMENT
  • Facility Address: 310 E TORRANCE AVENUE
    PONTIAC, IL
    ZIP 61764
  • Facility Phone: 815 844-7174
  • Facility Type: Other
  • Facility Type: Microscopy
  • Lab Director: JAMES SPORRER
  • NPI Number: 1255398517
  • Taxonomy: 261QC1500X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D0646839
LAB Type Other
Facility Name LIVINGSTON COUNTY HEALTH DEPARTMENT
Street 310 E TORRANCE AVENUE
City PONTIAC
State IL
ZIP 61764
Phone 815 844-7174
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 11/1/2024
Certificate Expiration Date 10/31/2026
Facility Type Other
Lab Director JAMES SPORRER

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