14D0884735 CLIA NUMBER - CLARK-LINDSEY VILLAGE

Laboratory Demographics

CLIA Number: 14D0884735

Facility Name: CLARK-LINDSEY VILLAGE

Facility Address:
101 WEST WINDSOR RD
URBANA, IL
ZIP 61802
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Facility Phone Number: 217 344-2144

Facility Type: Skilled Nursing Facility/Nursing Facility

Certificate Type: Waiver

NPI Number: 1033565882

Taxonomy: 261QR0400X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	14D0884735
LAB Type	Skilled Nursing Facility/Nursing Facility
Facility Name	CLARK-LINDSEY VILLAGE
Street	101 WEST WINDSOR RD
City	URBANA
State	IL
ZIP	61802
Phone	217 344-2144
CertificateType	4
CertificateEffectiveDate	4/8/2024
CertificateExpirationDate	4/7/2026
FacilityType	Waiver

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