14D1032087 CLIA NUMBER - BRYAN MANOR

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Field Name	Field Value
CLIA Number	14D1032087
LAB Type	Intermediate Care Facility for Mentally Retarded
Facility Name	BRYAN MANOR
Street	2150 E MC CORD
City	CENTRALIA
State	IL
ZIP	62801
Phone	618 918-3770
Certificate Type	Certificate of Waiver
Certificate Type Description	This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date	10/18/2024
Certificate Expiration Date	10/17/2026
Facility Type	Intermediate Care Facility for Mentally Retarded
Lab Director	MISTY D. WERNSMAN

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