14D0667715 CLIA NUMBER - WAYNE COUNTY HEALTH DEPARTMENT

Laboratory Demographics

  • CLIA Code: 14D0667715
  • Facility Name: WAYNE COUNTY HEALTH DEPARTMENT
  • Facility Address: 405 NORTH BASIN ROAD
    FAIRFIELD, IL
    ZIP 62837
  • Facility Phone: 618 842-5166
  • Facility Type: Other
  • Facility Type: Waiver
  • Lab Director: KIMBERLY SMOTHERS
  • NPI Number: 1447353727
  • Taxonomy: 261QH0100X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D0667715
LAB Type Other
Facility Name WAYNE COUNTY HEALTH DEPARTMENT
Street 405 NORTH BASIN ROAD
City FAIRFIELD
State IL
ZIP 62837
Phone 618 842-5166
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 Other
Lab Director KIMBERLY SMOTHERS

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