14D0665216 CLIA NUMBER - PITTSFIELD MANOR

Laboratory Demographics

  • CLIA Code: 14D0665216
  • Facility Name: PITTSFIELD MANOR
  • Facility Address: 610 LOWRY STREET
    PITTSFIELD, IL
    ZIP 62363
  • Facility Phone: 217 285-5200
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: MATT HAILS
  • NPI Number: 1942534375
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D0665216
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name PITTSFIELD MANOR
Street 610 LOWRY STREET
City PITTSFIELD
State IL
ZIP 62363
Phone 217 285-5200
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 MATT HAILS

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