14D0886490 CLIA NUMBER - HERITAGE HEALTH (D/B/A) BARTON W STONE - JACKSONVILLE LLC

Laboratory Demographics

  • CLIA Code: 14D0886490
  • Facility Name: HERITAGE HEALTH (D/B/A) BARTON W STONE - JACKSONVILLE LLC
  • Facility Address: 873 GROVE ST
    JACKSONVILLE, IL
    ZIP 62650
  • Facility Phone: 217 479-3400
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: DAVELYN PASAMONTE
  • NPI Number: 1447594155
  • Taxonomy: 332BX2000X - Durable Medical Equipment & Medical Supplies

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CLIA Record

Field Name Field Value
CLIA Number 14D0886490
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name HERITAGE HEALTH (D/B/A) BARTON W STONE - JACKSONVILLE LLC
Street 873 GROVE ST
City JACKSONVILLE
State IL
ZIP 62650
Phone 217 479-3400
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/19/2024
Certificate Expiration Date 5/18/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director DAVELYN PASAMONTE

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