14D0721178 CLIA NUMBER - HERITAGE MANOR OF LITCHFIELD

Laboratory Demographics

  • CLIA Code: 14D0721178
  • Facility Name: HERITAGE MANOR OF LITCHFIELD
  • Facility Address: 628 SOUTH ILLINOIS
    LITCHFIELD, IL
    ZIP 62056
  • Facility Phone: (217) 324-2153
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: JAMIE EVANS
  • NPI Number: 1710221429
  • Taxonomy: 332BX2000X - Durable Medical Equipment & Medical Supplies

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CLIA Record

Field Name Field Value
CLIA Number 14D0721178
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name HERITAGE MANOR OF LITCHFIELD
Street 628 SOUTH ILLINOIS
City LITCHFIELD
State IL
ZIP 62056
Phone 2173242153
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 JAMIE EVANS

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This page was last updated on: 5/18/2026