14D0875931 CLIA NUMBER - HAVEN OF ARCOLA, LLC, THE

Laboratory Demographics

  • CLIA Code: 14D0875931
  • Facility Name: HAVEN OF ARCOLA, LLC, THE
  • Facility Address: 422 E 4TH ST S
    ARCOLA, IL
    ZIP 61910
  • Facility Phone: 217 268-3022
  • Facility Type: Ancillary Testing Site in Health Care Center
  • Facility Type: Waiver
  • Lab Director: PAULA K. MASON
  • NPI Number: 1437115417
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 14D0875931
LAB Type Ancillary Testing Site in Health Care Center
Facility Name HAVEN OF ARCOLA, LLC, THE
Street 422 E 4TH ST S
City ARCOLA
State IL
ZIP 61910
Phone 217 268-3022
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/3/2025
Certificate Expiration Date 9/2/2027
Facility Type Ancillary Testing Site in Health Care Center
Lab Director PAULA K. MASON

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