14D0973071 CLIA NUMBER - MOULTRIE COUNTY HEALTH DEPARTMENT

Laboratory Demographics

  • CLIA Code: 14D0973071
  • Facility Name: MOULTRIE COUNTY HEALTH DEPARTMENT
  • Facility Address: 202 S MAIN ST
    SULLIVAN, IL
    ZIP 61951
  • Facility Phone: 217 728-4114
  • Facility Type: Other
  • Facility Type: Waiver
  • Lab Director: ANGELA L. HOGAN
  • NPI Number: 1538213285
  • Taxonomy: 251K00000X - Public Health or Welfare

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CLIA Record

Field Name Field Value
CLIA Number 14D0973071
LAB Type Other
Facility Name MOULTRIE COUNTY HEALTH DEPARTMENT
Street 202 S MAIN ST
City SULLIVAN
State IL
ZIP 61951
Phone 217 728-4114
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/25/2024
Certificate Expiration Date 4/24/2026
Facility Type Other
Lab Director ANGELA L. HOGAN

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