14D0668050 CLIA NUMBER - SANGAMON COUNTY DEPARTMENT OF PUBLIC HEALTH

Laboratory Demographics

  • CLIA Code: 14D0668050
  • Facility Name: SANGAMON COUNTY DEPARTMENT OF PUBLIC HEALTH
  • Facility Address: 2833 S GRAND AVE
    SPRINGFIELD, IL
    ZIP 62703
  • Facility Phone: 217 535-3100
  • Facility Type: Other - LOCAL HEALTH DEPT
  • Facility Type: Waiver
  • Lab Director: VIDYA SUNDARESHAN
  • NPI Number: 1437267234
  • Taxonomy: 251300000X - Local Education Agency (LEA)

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CLIA Record

Field Name Field Value
CLIA Number 14D0668050
LAB Type Other - LOCAL HEALTH DEPT
Facility Name SANGAMON COUNTY DEPARTMENT OF PUBLIC HEALTH
Street 2833 S GRAND AVE
City SPRINGFIELD
State IL
ZIP 62703
Phone 217 535-3100
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/5/2024
Certificate Expiration Date 8/4/2026
Facility Type Other - LOCAL HEALTH DEPT
Lab Director VIDYA SUNDARESHAN

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