14D0922679 CLIA NUMBER - PINCKNEYVILLE COMMUNITY HOSPITAL DIST

Laboratory Demographics

CLIA Number: 14D0922679

Facility Name: PINCKNEYVILLE COMMUNITY HOSPITAL DIST

Facility Address:
5383 STATE ROUTE 154 - PO BOX 437
PINCKNEYVILLE, IL
ZIP 62274
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Facility Phone Number: 618 357-2187

Facility Type: Skilled Nursing Facility/Nursing Facility

Certificate Type: Waiver

NPI Number: 1689646523

Taxonomy: 282NC0060X - General Acute Care Hospital

CLIA Record

Field Name	Field Value
CLIA Number	14D0922679
LAB Type	Skilled Nursing Facility/Nursing Facility
Facility Name	PINCKNEYVILLE COMMUNITY HOSPITAL DIST
Street	5383 STATE ROUTE 154 - PO BOX 437
City	PINCKNEYVILLE
State	IL
ZIP	62274
Phone	618 357-2187
CertificateType	4
CertificateEffectiveDate	12/4/2022
CertificateExpirationDate	12/3/2024
FacilityType	Waiver

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