14D0672768 CLIA NUMBER - COLES COUNTY HEALTH DEPARTMENT

Laboratory Demographics

CLIA Number: 14D0672768

Facility Name: COLES COUNTY HEALTH DEPARTMENT

Facility Address:
825 18TH STREET
CHARLESTON, IL
ZIP 61920
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Facility Phone Number: 217 348-0530

Facility Type: Other - LOCAL HEALTH DEPT

Certificate Type: Waiver

NPI Number: 1407039761

Taxonomy: 251K00000X - Public Health or Welfare

CLIA Record

Field Name	Field Value
CLIA Number	14D0672768
LAB Type	Other - LOCAL HEALTH DEPT
Facility Name	COLES COUNTY HEALTH DEPARTMENT
Street	825 18TH STREET
City	CHARLESTON
State	IL
ZIP	61920
Phone	217 348-0530
CertificateType	4
CertificateEffectiveDate	1/19/2023
CertificateExpirationDate	1/18/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024